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Home My WebLink AboutMP22-116 Qy� 4R t co 4.°JJ�v t . 19 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.orQ TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE February 21,2024 Win Ridge Realty LLC c/o Alena Hakanjin 24 Rye Ridge Plaza Rye Brook,New York 10573 Re: 114 South Ridge Street, Rye Brook,New York 10573 Parcel ID#: 141.27-1-6 This document certifies that the work done under Mechanical Permit #22-116 issued on 7/22/2022 for the installation of two new rooftop HVAC units have been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to QyE BR(�� O� 2m 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: 7 -'5 D U J!, fZ 1 O 11 S�/L�`= 1` DATE: Z ` g - ZOL PERMIT#_M P 22 ISSUED:2-2Z-ZL SECT: A//.z 7 BLOCK: LOT: LOCATION: /� y0 d a N�� (Z J L� i 7� OCCUPANCY: ❑ Violation Noted THE WORK IS... 3 PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas S U 10&2 ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER �E BRC�k. • 1982 BUILDING DEPARTMENT ❑BBUILDING INSPECTOR 9-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 : I I Ll S n(,7( k I A�J DATE: PERMIT# / 2 P Z 2-1 0 Co ISSUED: )- Z z-Z 2SECT: /`//• Z 7 BLOCK: i LOT: _ LOCATION: I OO � 4rP N V R L L2 ,J L1'y ��s OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION[I ( log` Natural Gas C �� C�CCI� Ow 1 IP U j , Vo r- ❑ L.P. Gas Mal /SU�J 1') J G We Z (/.y Pcl 41— ❑ FUEL TANK ❑ FIRE SPRINKLER A10 NL ❑ FINAL PLUMBING Jr �fn ❑ CROSS CONNECTION D / Ga'FINAL ❑ OTHER �� Vl : w a a� /.�•1 ICI W � v v � � ./ � � r � O r l '� M F+ 0 y a M � U ' _ 1 u 0 � Ir a 3 0 0 w v w H > A � V = �■■■'{ N W Q w z = aka a00 a u a 10, x � o 40, r d II Ts.11 ~ 0 O F 'v m W V O y ^w w0 O aJ14U S V v5 W H c z di d (n U V 0 a r"1 �+ a z a O ° v dd � a s ' BUILDING DEPARTMENT 2FICENED VILLAGE OF RYE BROOK J U L 2 0 2022 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.ryebrook.org BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING,VENTILATION AND/OR AIR CONDITIONING EQUIPM 6 ENT FOR OFFICE USE ONLY: PERMIT#: /�',}��'f/ Approval Date: Permit Fee: $ -5& fib It Approval Signature: Other-- Disapproved: (fees are non-refundable) REOUIREMENTS 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. Application dated, 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 fisted 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. I. Address: 4 cSQ(Jfii-4 rLl yC 5 SBL:� fl, e)7-1 Zone; 2. Property Owner: U�1 w 12_1 1() �_r� Address:-bA —5Os�r Y-1 Q-wt�L 5 i- . Phone#; q(L} - 40�- ?5��Cell#: 2OO - -43)email: Pf=E .I.1 (� CJU l i�1fl)u , CGIt,( 3. Contractor:C' er ,MV-=C 4 3t-=nt,ArjEf:� . T Uk,-C Address:40 -mk-14f•� M Phone#:2U3-''S3— 3-�3Z Cell#: 20 3 - Ll 43 - 53-yam email:Qfl1J�r--&C A3Tfit--f*L G ky�rA t CAI L 4. Applicant: 9M---AS ( `} Address: Phone#: Cell#: email: 5. Scope of Work:New Installation( }•Replacement( )-Removal( )•Other( ): 6. List Equipment: (F---X.1 ST4 VVC, Y'T U)S L,z> Lx. 1'T4 tj e(,—� T-41:4�il r4 12 t/) PerC�t--�q Q&' kp-R '1 A 7. Location of Equipment: V\A"" 501Q N1 �- 8. Method of Installation/Removal fist all ) C ) -'µ' TS ( equipment needed to perform job): 5 i CaOt� •� �'Z T� 1 8/1 212 02 1 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: bi /4) W _E7 ,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 Ic al owner of the property to which this application pertains,or that(s)he is the r&Ou , via QbE�s for the legal owner and is duly authorized to make and file this application. (indicate architect, ontractor,agent,attorney,ctc.) 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 770-�s, _ Sworn to before me this day of 20 day of 20 � Ile �,47 -i zot�n Skqlatdre of propev Owntr Signature of Applicant 1p-Iye!) L1j*-- oykvl0 t�i�ST tL�1 Pri Name of Property4� r Prin Name of Appli tat Nvotaj public N o ry Public ate Do Now York No. OI SA6003882 KFILY SaMD[ER Qualified in Westchester County Notary Public, State of New York Commission Expires March 9, 20—,4 , No. D'S,, j0S8 F2 This d6 leted in its entirety and must include the notarized signature(s) of the legal ovr'IIneri(s)10T M6j € =r id 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 O Z z Q a z a_ A (� f �FOO ZLU v Z W a � J � � ci QJ ( ma d Z � m J - s�L, •. (I1�I�11{I1—I{I�I1'1(�V�11 (il „ R I 1 1 n � �wav ywr,. El Y Y --s- oAwrne�uro �e 1�, ➢4 �i.�E of ! - 4 �\ — ti �i� ! I \ I I \ o� HIM 111111 Hill \ w Z ow: \ Zw0 Wzw OMw1 Zw rn I a, ��} 210, a0w� ➢� Imo a \ A \ 0- - ❑ I \ ! EDO Ow x \\ WOO U g o \�\ > ➢`1i •FE a Sc 1 LoMR LEVEL ENI*S COASMEC-02 PS ,a►`oRo CERTIFICATE OF LIABILITY INSURANCE DATE 5/1712 � 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 CO JACT Paul A.8"0 AssuredPartners New England,Inc. PHONE 20S 614-78�5 _ FAx 100 Beard Saw MITI Road (A/C,No,E,q:( tAIC,Nei:(203)814-7863 Shelton,CT 06484 J-DUiss,Paul.SuiloJrGAssursdPartners.COM agURl1 _APFOROINO COVERAGE _ NAR.e INSURER A:American Fire III Casuaft CO. 24086 INSURED INSURER 9:Ohio Smft Insurance Conmily 24M Coastal Mechanical Services,Inc. INSURER C:Ohlo Caaualtf/Nit.Co. 2074 40 Hathaway Dr. INSURER D. Stratford,CT 06615 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. 161—as 7— TYPE OP INSURANCE �zIX' POLICY NU�I EFF Lea A X COMMERCIAL GENERAL LIAISLITY EACH OCCURRENCE190000000 CLAIMS-MADE X OCCUR X sSt BKAEs167 ! 12/17/2021 12f17f2022-.DAMAGE TO RENTED f—� PREMISES(EA - MEDEXP_ etie coon 16,000 PERSONAL a ADV INJURY 8 1,000,000 �GEWL AGGREGATE LIMIT IE8 PER GENERAL AGGREGATE 2,000,000 X POLICY LOC PRODUCTS-COMPIOP AGO 2,000,000 OTHER _ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,o,000 (Ea aocldenU _—— X ANY AUTO X BASS8336167 12/17/2021 12/17/2022 BODRYINJLI OWNED S fflr.ED AUTOS ONLY _ AAUuT1�aOss j BODILY PCIVRY .X.AUTOS ONLY ..X AA OPERjp ]YS C UMBRELLA LIAR X 1 OCCUR: EACH OCCURRENCE 2,000,000 X EXCESS LIAR cLAIM8.NADE X US08tS2a167 12/17/2021 1211712022 AGGREGATE s - 2,000,000 DED X RETENTION$ 10,000 C WORKERS COMPENSATION X AND EMPLOYERS'LUUIILITY ANY PROPRIETOR/PARTNERIEXECUTNE Y/N XtI110883s{1s7 1211/2021 12H/2022 E.L.EACH AGENT I VIA 800,000 �FFICEr M%IW EXCLUDED? NIA aS (Mandatory In NHI 18 8 - 000,000 If yyes describe under DESCRIPTION OF OPERATIONS bebw 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddMonel Remarks Schedule,m"be*Method If moo spec Is retnored) Village of Rye Brook Is 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 StreetACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE .-I�!/tTC✓Q000 ACORD 28(201UOS) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PORK Workers' CERTIFICATE OF STATE Compensation BoardNYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name 3 Address of Insured(use street address only) 1b. Business Telephone Number of Insured Coastal Mechanical Services,Inc. (203)9533732 0 Hathaway Dr. 1c. NYS Unemployment Insurance Employer Registration Number of Insured Stratford,CT 06615 Work Location of Insured(Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 06-1450112 2.Name and Address of Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Ohio Casualty Ins,Co. Village of Rye Brook 3b. Policy Number of Entity Listed in Box•la" 938 King Street XW0583361167 Rye Brook,NY 10573 3c. Policy effective period 12/1/2021 to 12/1/2022 3d. The Proprietor,Partners or Executive Officers are ®included.(Only check box if all partners/officers 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"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'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'com pen satlon 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: Paul A. Suzio (Print name of authorized representative or licensed agent of insurance tamer) Approved by: 00aZd 5/1 712 0 22 (Sig t e) (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: (203)514-7863 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.