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HomeMy WebLinkAboutMP22-157 �yE DR CCV CC VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.tyebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE December 3,2024 David Simon&Beverly Simon 62 Windsor Road Rye Brook,New York 10573 Re: 62 Windsor Road, Rye Brook,New York 10573 Parcel I D#: 135.60-1-23 This document certifies that the work done under Mechanical Permit#22-157 issued on 10/20/2022 for the installation of a new condenser and a new gas furnace has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �lea?EBR2m 1932 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 : V ll�� (N ]S 7G� DATE: ( (� PERMIT# //)` q c� _ ISSUED: "SECT: BLOCK: LOT: 7- 3 7 LOCATION: � �3 �� 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 i i i i N `� N W •� ,� v rx v W � X a li 0O e ~ W H U N hn � �,r ^� •� N w W e Y ` a ° ° v1 010 W R. O o O W z O z o aU uV o Q uz � aQ C i N W I a, u V Q H C% U iry 0 � a °q I chi \c 00 F+�i �-1 �i P•' � � w o � � �"y w � p 0 o .d O 00 �/ w V y z sr A 0s � ° ' o F-1 Qn U A W. O W 9 0 0 z F" C G °� w U O Q u 14 W I o N Z z O � '~ a 0 � � �� BUILD MENT VIL F OF RYE`; OOK III OCT 2 0 2022 938 KING FT RYE BR .Y ,NY 10573 I :.Q. .: 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 g: Approval Date: OCT 9 2022 Permit Fee: $ Approval Signature: VVVOther: Disapproved: (fees are non-refundable) REQt1I1REA1ENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: I. 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=$350.00/unit. 5. Inspection by the Building Department for removal and/or installation. (48 hour notice required) 6. Electrical work requires a separate Electrical Permit& Electrical Inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, 10/18/2022 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the 14VAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County, State&Federal laws, codes,rules and regulations. I. Address: 62 Windsor Rd,Rye Brook,NY 10573 SBL; Zone: R-7 2. Property Owner: David&Beverly Simon Address: 62 Windsor Rd.,Rye Brook,NY 10573 Phone#: 914-666-5600 ext 326(David Simon) Cell#: 914-262-6346 email: dsimon@hollislaidlaw.com 3. Contractor: Stevie Air,Inc. Address: P.O.Box 337,Middle Granville,NY 12849 Phone#: 845-216-6943 Cell#: Same email: ste0eair04@gmail.com 4. Applicant: Stevie Air,Inc. Address: P.O.Box 337,Middle Granville,NY 12849 Phone#: 845-216-6943 Cell#: Same email: stevieair04@gmail.com 5. Scope of Work:New Installation( )•Replacement(x)•Removal( )•Other( ): 6. List Equipment: Carrier 96seer Gas Furnace 2 Stage,Carrier 16seer Condensing Unit 7. Location of Equipment: Mechanical room,replacing existing furnace,install air conditioning 8. Method of Installation/Removal(list all equipment needed to perform job): Carrier 59TP6B BOV17-16 24ACC630AD03 Condenser I 8/12/2021 K Af111P M1E 4k 1'i fN i:-CTH1A 13'UF Wt_}i1 t7�E!i1Eli In t✓G.. e.lt G i fi/a bring Jul% swwn, ie(wrxx uld omms that he AM a the applic4ril aMrie nAmL-,d 1I.rr'vrs-°I rat,crd'gri'F r Its alvixarll ,tat turlher trans Ittan ty hr r.the IeeAi fYAm of ttw(Jit"m to utlll h nh Afflijtkia prmun-i it(1hAt I stilt L%the c far the kaw :-Ixv M-4 n%*^-ILM NSwcd et+,r AV and We IfNa appllcallar+ r+Jaal:u.!rrI ..xluur A$" ahax V'.I That all 4alowwrils vcrrrwoed heron an true In the two al his'her km-ml dw and k*rllef and rail am*;irk(vrfurrnetf a ux CgWSA t-Int at llic aha.r wellirinp Fro(tert4 %Ill ht ttr Cunliarrna A:C ultra Ilx J&dlls as ut flinh•tnd anralncd in thn applic-211 l err!m<wy aeertntw�+,.yF.rlrtrn+.erg clan,ra.l v1>t'C�N:it�srl._as wrll rr,In x-crwdarkar wrlh tier*ir..S-nrk Sealy IAlf/wm Floc RntIIINHI&RuahlJill C'I%k Ilrr e'tste nl thr NllIffV iIf ltyt fbLJkP1*Wall rlther 1il'04-atrk IitiAv rNrlrtWt,r Nrkt rr;1Llrtnrn tivnirn tia I+ctlHr lafl Ihl, St4JM n 111 Ilr?;rr mr 0-n '6ZM- lnit IIf Pftgwrtti Ow SIEttMirr l,t •Irk rt!,�.►,J',T ,._ David Simon NotatyPublic, �atec��{ewYork� blow Na. 02b�Srb�47 )�L� lc David Simon Qualified in Westchester County Notary Public, State of New York Commission Expires October 30,20aCP No. 0351�064178 (�ualificd in 4Vestcllester County Cuutt,tissi44A�x l� irtiiit0 20rl . . ck1111;11-MJ In iu clAilck :1taJ Ititat uwlw3c lies txlLutLrJ aLLnxtuiOal of the legal o-ArXrt%I of ttx rlihle ^'prn(Iertr .iml the.irTl ward of record In thr 4rutl-r%prof i3rd lion :tMix•.uttin wo 1worwrtt o Iarllllme i In ilia enure,% ;tnd oar nail r'I'e1*d% mgfelt%hall he deemed fall I ami t oull arwi aril he rellJmM try thr aprillca;nr G�,46,n VI e Z re Wje__ -'fit, s oc�� 202 r CHRIS7OPNER J.BRADBURY Notary Public,State of New York No.01 BR6159985 Qualified in Westchester Count[_L 3 Commission Expires January 29,20 s a � N M C N N eq � a oo z W 6J N � � � „_• aS W o v H � x in en 1 � H rn W g zN o H 8 y O W ►--i � toen vt � 6' � °O 'J G t .. N F Ucr co w 0 Z (alb 00 � _ � �i F ,, w w z w U z w ° � w � � : 00 M1 z w MM� M Ln H N W G V a ito : r ✓ A � Uw � a O O Z� < � Ln V g x orA H V A a z a oA f H O U W w aJ �I � a ►� z � w z � : z G � p CEME BUIL01N 10EPAERITMENT VlL ' E ClF RVEi'✓ OK DEC 19 2022 938 KINCDD X�"!T RYE!Bt;x*,NY 10573 `1'09 � !i VILLAGE OF RYE BROOK > ;or, BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY ���-�.� / EP#: DEC 1 9 202 , Approval Date: Permit Fee:S Approval Signature: Other: Application dated,,r�)—) is hereby made to the Building Inspector of the Village of Rye Broods NY, for the issuance of a Permit to install atuLor remove electrical equipment,wiring, textures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be to conformance with all applicable Federal,State.County and local Codes. 1.Address: 62 Windsor Rd, Rye Brook NY SSL: [?5,60- l-.�3 Zone: 2.Property Owner: d_ Beverly Simon Address: Brook 62 Windsor Rd, Rye Phone#: 646-872-3351 Cell iM: email: .._ TV—an Fabian Pardo Wyck Street, Ossining NY 10562 3.Master Ekcirietan: Address: Lie.#: 1670 Phone#: Cell#:_914-557-2771 email: _ardoQw�utelect�ic.com Company Nam: Westput 24/7 Etectric 8 Van Wydc Street, Ossining NY 10562 4.proposed Electrical Work/Fixture Count:'_ Inside/Outside:disconnect switch for furnace on existent circuit ...�.._..._._. ._......._- Supply and instal v irng for..1.GFCI on existent circuit I weathegX001 r Geptant "'Party Flectrica l Inspection Agency: Statewide Inspections Services STATE OF NEW YORK.COUNTY OF WESTCHESTER V L 1 being duty swom.dues and states that he,shc i,the applicant above named.and does further iinini nano of rr i�i?€tsal;tigning J,tie a{rplic alit i , state that(s)hc is the legal owner of the property to which this application pertains,v. 1 Gin It &:'jtcarihitdtit.conowtor.,tgmt.Atornc),rti.) The undersigned further states that all statements contained herein are true to the best of hisiber knowledge and belief,and that any work performed or use conducted at the above captioned property will be in conformance with the details es set forth and conuined in this application and in any accompanying approved plans and specifications.as well as in accordance with the New York State Uniform Fire Prevention 8r,Building Coale,the Code of the Village of Rye Brook and all other applicable laws.ordinances.and regulations. Sworn to before me this 2T' Sworn to folic me th s day of 1-)RX P.rw6e4- ,20 :a_ day of ,20 X- Signature of Property Owner SignStUrt DfAfA plicanyi A tier U an 4 Natic Nis David Simon SARAH VELIN Notary Public,State of New York No. 02SI5064178 Notary Public,State of New York Qualified in Westchester County Registration#01 VE5037473 Qualified in Westchester County 6232022 Commission Expires October 30,20- commission Expire$Der.27,2022 STATE WIDE INSPECTION SERVICES, INC. Service TVitli Integrity 0:0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# Date Bldg Permit# Sq Ft Plumbing Permit# Final Certificate# City/Village Zip Building Dept, County Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑ 1st Fl. ❑ 2nd A. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect )unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation D EC EME DEC 19 2022 --v ir-N 0, Ck- F VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at anytime of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address Name License# Date Signature Address City/State Zip Code Company Phone# D E C E��E State Wide Inspection Services 2 DD CAC) 1080 Main Street JAN 19 2023 Fishkill, NY 12524 845 202-7224 Phone 4-1 owff U as VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Westput 24/7 Electric Inc Beverly Simon Fabian R Pardo 62 Windsor Road 8 Van Wyck Street Rye Brook, NY 10573 Ossining, NY 10562 Located at: 62 Windsor Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: 22-307 135.60 � 23 Certificate Number: 2023-0064 Building Permit Number: MP22-157 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 62 Windsor Road, Rye Brook, NY 10573 The Basement and Exterior were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 18th day of January 2023. Name Quantity Rating Circuit Type GFCI Circuit 01 WP Receptacle 01 Disconnect Switch for Furnace 01 HVAC System 01 Disconnect Switch 01 tow Officer; Frank 1. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. 1II, ,► � L � � L� Stevie Air, Inc. 845-216-6943 OCT 2 0 2022 PO Box 337 VILLAGE OF RYE BROOK Middle Granville,NY 12849 _BUILDING DEPARTMENT Contact: Mr. & Mrs. Simon 62 Windsor Rd. Rye Brook,NY 10573 Email: dsimon ,hollislaidlaw.com bcsimon(iOptonline.net October 10, 2022 Stevie Air, Inc. is hereby authorized and directed to do the following work: To remove and dispose of existing equipment. To install one Carrier 96 SEER Upflow Two- Stage Gas Furnace(59TP6B80V17-16) in boiler room and to install one 3Ton Evaporator Coil in plenum. To re-do return duct and install return fixer. To replace existing supply duct work and insulate and exposed duct work outside sheetrocked basement. To install one Carrier 2 'h Ton 16 SEER Condenser(24ACC630A003)outside on slab and to connect to evaporator coil with refrigerant pipe To install PVC flu piping to outside. To re-connect electrical and gas piping. One-year warranty on condenser and ductwork from date of installation. Ten-year warranty on compressors from manufacturer. Twenty-year warranty on heat exchanger from manufacturer. Warranty does not cover fire, flood,theft, or misuse. No warranty on existing duct work, gas piping, refrigerant piping, or electrical. Price for installation at$16,500.00. Price includes permits. Price does not include electric or thermostat wire. Payments to be made: 50%down and balance due upon completion. Price subject to change after 10 days. Steven Bucciero, President Signature of Buyer/Date HVAC Specialist, Stevie Air, Inc. La ✓;% 1'�y 4. 'i. ,V �. 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At 15,1 laftd pao i f ltxttnniaily t,rimilaitd Io"ret lefetr oviliVe kL%wL in the %i/m mtm kill It P"Wor d in aMttrf lumwx Im tftr anh pitytsr tlV/al'rLai itiUil,fLelYe.sat3 Y F%arrne a►U,►a{itaYaYllfKlaM1. Liss" ITN rthnrM it 411111 C1fLnday f21Yl•.rmhrd tetrT leig rt'YAzx sal quire gsaatrm It on primiak asilaC etatch cahariunrlct» L• ucaraw or ri wive of oelcLt t rmr ar MODEL NUMBER NOMENCLATURE 1eNoncomM wrMin. r: e Y r I • • M � • » �.w -=vamp �« ����� • tali �!� • �� f.Ngp h •. 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'-f.d I 6 II-31P m�9U.31 I I t 1 1 V- 'L It GMDE SMIUM 'ATIONS Fvrsitr a Al-wan,tttdlil a.e JpI-fdc% II.„nr ..F::t- -hat a Ruh aped. -Yrtdk"wal fvmoc; Iry,aw tatth rtslaral pn.v priVenr Nws+ry- —Fhah'npol.�ayy astbnnal aac+uo-rI all italutml lift pnytwcl I,wl t ua 1 no.-ws.ti dtdl M • 11'Il YiLSNNNL�[ Au Jcb•art till lK Jr fhrirfulh al D St?!h L)ad will lat Llcw#rtat,ad.J add o.ndtu.iod n,the cusctd M%%l/ K f, ctlnnal%Hit'pfc%wv 1141 CSh 23 doilptl laaatlnd k--s also-ftad trntal fwrALwa IdtrrttaVmt dlall Pv &Vh., __ 1s Imarl, uido Utat will be turd pats act ifiad 1" C5A tar ilac.wicnt A191 Z in I Woe bcifhl in ream►I.Mulr-Olv I. '1 414 kA,' I Amipt tasdanl ke pit-tnrd.ttltral him"% I.nit 11aig1a %tall lv if ImRI wtft kf u+Il and t.N:m if. Ct-A 81. Ktal! and Olde F'mm T labci. L'nil in IMMI r'adl wall plrntam rlTkmr-? lMnj rill Ira perl;vm[d per the onrtnl 114* Ieit ptn[cthdc■a Barad a the F aktaa Legion I INO wilt k rartllMd trY �rfnncm•1 and litre to the Ekarnl rrtpph aaWl be 115 lolls.10 FFt rtyFk-phac Imeliad 1 'h Situate-wilra JW third be AWG.ta■asrtaal ftoa attt laecll AHtl tahap of 111.449 Il•rypc drwCnerd -ilea■- lwra►a .h■11 h Ural will ts:t the .-.treat Fcdtal Trak Cimamonam Fnor amps rfttr■rnr'r Ia1.1 ctw..1.1`•.�n.w. hrliarrs,%WI =OHMalNiwr aRafu k.umiite of li■c pr•..lrr2 dada alolifritail ainouncu and L'ut r-I -. -Iuctc- v uu_a tY a.Aox Lai% add o %Ltol add Jcvriltittaa fu apc.ifil.f.dtrn tale n dlaba tilltal.ttsttlta 1, nA.,1�.un: n,trola.tlacr'.Icutnmc>drlahom. Wreruw llftrr J"higion Ut sttecifN W can n[trt aattnan Fku 11aLnoa. I + .-di ieta.tr mil N.rar•� ..rube ri: nxlxf•k era rrtru�o MIIPWy hell MIANUX1% -hall N I.1'ms :0r...#.,e.ItSr4a[r afaf..11M trill rat 1nll-atilt-ertmp.t:SMA War ant appaird .�IGI.IUs1 ItltI.S r6�an..WtaaulL. �t.Nc+Wtlerrl Hal FrL1 It+•Y i ul.. 4+,rt taro Ht.t F t.f.1Mt.,r.. twavanlc-1 N,nrst Whorl%tc:. be.arsdnnrial Iyyc. -IalKdl► an! tiorrtlr� Said ca.lut�cfa .hail h A ■ dunlna, u,rl Jtttunullr bduwaal. Bkrrra ntttY of ECb lypc still Lm (krA-Ilr:urh of fa-dad-tube JL%ipi ilia appLnl tit aiwiltr■alit Iwnrt`'lrmh liflm-rid wilt walvd hall hrannr. + hp N k,Nnr pnwun dad Fa-c tnndmlt raftbit sftW Mtal(M.IWO RPM tgctalln/ -Wrf%"Ia611+Y Af4I%ear Mwried Ill~tu».v Shall Irf dirM dri%v rrJ aufl o-vrttaj lu dlw blu.v luoigd W Itdt■.e rd)liduu Cwtttvis -hall utaldc a ull.Io-prtt.xfeac-batwJ IfAvol W.4 llatta II*Wa_ tklL 41K i-virtl heard will at Ica! In wn-%v Fillet. .redo J*tay al r.did pt.uli.flaaWdog LED 1pM wt Aw auwui.AFurrwc droll hair scueFlk-lYpc fi4r. F ilia chili!tc in edit-Irar iragfr frill rlmell all taalrtt hrhArrtatt ill Ina Illttcw. add a asp[:rabJc swrmtliac-hpc cintrc pnncswn fi-nc Mtraipl- Irma\—_A ImmI An artremory tigilly rfhnrm lill"a -frhltrAal wstrlp<m,41LrYt•ra(tlapnt vparalr Nowsr fpct.fc i,r Filial is s.■ildir all as Uptiu& NL-Jia Fillta. Irta Will hl(lt Mat lost Lol"g,NSVI rn-drat.•ani mrinfnntla ran LMML C,,fRalwla fan "vd diN he adµllikl ff.0 lla Ll4,rnl.5W. t a.e+C,hail hr rd nor to Ira.t rc..mtnm,rn Vc-rAnlod deal l"ut,in6 aiArw will.be ukasla Frctwaca�14 oil 4100 CFM Fat 1hd k dMM M,nx ■vt ill ar .Ntranraantf Irattfm will XW Incdack rrrrprran *,dur=ar =M" In tha owyltrg nwadc hit anpmwrd iaalav mtful ball Fee tMu-apm!r5C Jni4rt Atirnllhlkauclt I■hei a TQ,-ppll Is itital[d n ilia 4t ffTKVBl 0■rrMtt and Garr c"-aata N Yarn a.r.eaepra fI-oat friars[rtaa I-s of "Oft w M•4v0 aiiawIMM Is101asof tMsssAlisoLdwMA 6060604"Warrralp go"owls aatllw"Mywsa gavk a Wrn _GM It 4A • Performance'" • Air Conditioner Refrigerantwith Puron@ Currier to 5 Tons turn to the expert� Product Data INDUSTRY LEADING FEATURES / BENEFITS Efficiency k4 "ram;; • 14- 16.5 SEER!11.5- 13.5 EER • Microtube'rechnology- refrigeration system t1 3 'litlj]S lt,I�i���,+�I� T • Indoor air quality accessories available !, t,,,,1►11� ?1�111111 Sound • Sound level as low as 72 dBA • Compressor sound blanket standard Comfort ; 1}T ) �j` �i • System supports Edge Thermidistat" or standard 1i �Jt°qlj J 1f11J11 thermostat controls }] I ii'�j;sJJ1)1JIlJJ Reliability • Puron- refrigerant - environmentally sound, won't deplete the ozone layer and low lifetime servce cost. Pe.rtormance p • Scroll compressor 1 ur®n µ- • Internal pressure relief valve • Internal thermal overload • Filter drier Carrier's Air Conditioners with Puron'- refrigerant provide a • High and low pressure switches collection of features unmatched by any other family of equipment. The 24ACC has been designed utilizing Carrier's • Balanced refrigeration system for maximum «liahilin Puron refrigerant. The environmentally sound refrigerant allows Durability you to make a responsible decision in the protection of the earth's WeatherArmor„ protection package: ozone laver. This product has been designed and manufactured to meet • Solid,durable sheet metal construction Energy Stare criteria for energy efficiency when matched with • Louvered coil guard appropriate coil components. Refer to the combination ratings in • Baked-on,complete outer coverage, powder paint the Product Data for system combinations that meet Energy Star,' guidelines. Applications • Long-line - up to 250 feet (76.20 m) total equivalent NOTE: Ratings contained in this document are subject to length, up to 200 feet (60.96 m) condenser above change at any time. Always refer to the AHRI directory evaporator,or up to 80 ft.(24.38 m)evaporator above (ww•wahridirector.v.org) for the most up-to-date ratings condenser(See Longline Guide for more information.) information. • Low ambient (down to -20=F/-28.9'C)) with accessory kit MODEL Nt1MBEIR NOMENCLATURE 1 2 3 4 5 6 7 8 9 10 11 12 13 N N A A A/N N N N A/N A N A/N N N 2 4 A C C 6 3 6 A 0 0 3 0 Product Product Major Cooling Grille Series Family Tier Series SEER Capacity Variations Open Open Voltage Series O=Not 0-Not3=208/230-1 0 24=AC A--RES AC C=-Performance C=Puron 6-16 SEER A=Standard Defined Defined Original Series l) Peron _ c UL us Use of the AHRI Certified TM Mark indicates a manufacturer's participation in the This product has been designed and manulamured In inset Energy St.,criteria for energy efficiency when: program For verification matched with appropriate coil componema However of certification for individual proper refrigerant charge and proper eir flow we critical products.go to �C O (l900 to achieie rated capanty,and efficiency. Installation of wWYl.ahfldlfeClOryAfg_ a this producf shcuId follow all manufac:unng refrigerant OMI-SAI Global charg1ng and si r"ew mstn,ctinns Fraure to conti m proper charge and air now may reduce energy efficiency and shorten equipment life. STANDARD FEATURES Feature 18 24 30 36 42 - 48 - 60 Puron Refrigerant X X X X X X X Maximum SEER• 16.0 16.0 16.5 16.5 16.0 16.0 16.0 Scroll Compressor X X X X X X X Field Installed Filter Drier X X X X X X X Front Seating Service Valves X X X X X X X Internal Pressure Relief Valve X X X X X X X Internal Thermal Overload X X X X X X X Long Line capability X X X X X X X Low Ambient capability with Kit X X X X X X X High Pressure Switch X X X X X X X Law Pressure Switch X X X X X X X Compressor Sound Blanket X X X X X I X X Louvered Coil Guard X X X X X I X X •With approved combinations X=Standard PHYSICAL DATA UNIT SIZE-VOLTAGE,SERIES 18-30 24-30 30-30 36-30 42-30 48-30 60-30 Operating Weight lb(k ) 136(61.7) 163(73.9) 187(75.7) 180(81.6) 234(106.1) 248(112.5) 337(152.9) ShippingWe' ht lb(k ) 163(73.9) _ 198(89.8) 204(92.5) 219(99.3) 281(127.5) 291 (132.0) 372(18a.7 Compressor Type Scroll _ REFRIGERANT Puron (R-410A) Control TXV(Puron Hard Shutoff) Char lb k ) 4.60(2.09) 00(2.72) 6.81(3.09) 1 7.00(3.18) F 8.62(3.91) 10.50(4.76) 14.50(6.58) COND FAN Propeller Type.Direct Drive Air Discharge Vertical Air Oty(CFM) 1881 _2814 2614 3223_ 3810 4048 4046 Motor HP 1/12 1/10 1/10 11 12 1/5 1/4 1/4 Motor RPM 1100 800 1 800 800 a00 800 800 COND COIL Face Area(Sq ft) 11.50 15.10 17.20 17.60 25.15 20.10 30.15 Fins perIn. 25 25 25 25 25 20 20 Rows 1 1 1 1 1 2 2 Circuits 3 4 4 4 6 7 8 VALVE CONNECT.(In.ID) Vapor 314 3/4 3/4 7/8 7!8 Liquid 3/8 3/8 3/8 318 318 3/8 3/8 REFRIGERANT TUBES(In.OD) _ Rated Vapor* ----- -- - 3/4 -- _ 7/8 1 1/a Max Liquid Line 318 •Units are rated with 25 It(7.6 m)of lineset length. See Vapor Line Sizing and Cooling Capacity Loss table when using other sizes and lengths of lineset. Note: See unit Installation Instruction for proper installation. t See Liquid Line Sizing For Cooling Only Systems with Puron Refrigerant tables. 2 REFRIGERANT PIPING LENGTH LIMITATIONS Liquid Line Sizing and Maximum Total Equivalent Lengthst for Cooling Only Systems with Puron®Refrigerant: The maximum allowable length of a residential split system depends on the liquid line diameter and vertical separation between indoor and outdoor units. See Table below for liquid line sizing and maximum lengths Maximum Total Equivalent Length Outdoor Unit BELOW Indoor Unit Liquid AC with Puron Refrigerant Maximum Total Equivalent Lengtht: Outdoor unit BELOW Indoor Size Liquid Line Line Vertical Separation ft(m) Connection Diam. 0-5 6-10 11-20 21-W 31-40 41-50 51-60 61-70 71-90 w/TXV 0-1.5) t.8-&0 &4-&1) (6.4-9.1 (9.4-122) 12.6-152 (15.6-1s.3 1s.6-21.3) 21.6-24.4 18000 1/4 150 150 125 100 100 75 —— -- AC with 3/8 5/16 250* 250* 250* 250* 250* 250* 250* 225* 150 Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 250* 24000 1/4 75 75 75 50 50 —— —— —— —— AC with 3/8 5/16 250* 250' 250* 250* 250* 225* 175 125 100 Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 250* 30000 1/4 30 —— —— —— —— —— — AC with 318 5/16 175 225* 200 175 125 100 75 -- -- Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 250* 36000 5/16 175 150 150 100 100 100 75 -- -- AC with 3/8 Puron 3/18 250* 250* 250* 250* 250* 250* 250* 250* 250* 42000 5116 125 100 100 75 75 50 —— -- -- AC with 3/8 Puron 3/8 250* 250* 250* 250* 250* 250' 250* 250* 150 48000 AC with 3/8 3/8 250* 250* 250* 250* 250* 250* 230 160 -- Puron 60000 AC with 318 318 250* 250* 250* 225* 190 1so 110 -- -- Puron _ ' Maximum actual length not to exceed 200 It(61 m) t Total equivalent length accounts for losses due to elbows or fitting.See the Long Line Guideline for details. -- =outside acceptable range Maximum Total Equivalent Length Outdoor Unit ABOVE Indoor Unit Liquid AC with Puron Refrigerant Maximum Total Equivalent Lengtht Outdoor unit ABOVE Indoor Size Liquid Line Line Vertical Separation R(m) Connection Diam, 26 26-50 61-75 76-100 101-125 126-150 161-176 176-200 w/TXV (7.6) .9-162 (15.6-22.9) (232-30.5) (30.s-36.1) (36.4-45. (46.0-53.3) (53.6-61.0 18000 - 114 175 250* 250* 250* 250* 250* 250* 250* AC with 3/8 5/16 250* 250* 250* 250* 250* 250* 250* 250* Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 24000 1/4 100 125 175 200 225* 250* 250* 250* AC with 3/8 5/16 250* 250* 250* 250* 250* 250* 250* 250* Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250*. 30000 1/4 30 -- -- — -- -- -- -- AC with 318 5/16 250* 250* 250*_ 250* 250* 250* 250* 250* Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 36000 5116 225* 250* 250* 250* 250* 250* 250* 250* AC with 3/8 Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 42000 5116 175 200 250* 250* 250* 250* 250* 250* AC with 3/8 Puron 3/8 250* 250* 250* 250* 250* 250* 250* 250* 48000 AC with 3/8 3/8 250* 250* 250* 250* 250* 250* 250* 250* Puron 60000 — AC with 3/8 318 250* 250* 250* 250* 250* 250* 250* 250* Puron 'Maximum actual length not to exceed 200 R(61 m) t Total equivalent length accounts for losses due to elbows or fitting.See the Long Line Guideline for details. -- = outside acceptable range REFRIGERANT CHARGE ADJUSTMENTS Liquid Line Size Puron Charge oz/ft 3 --- - 0.60 /8 (Factory charge for lineset=9 oz) 5/16 0.40 1/4 - - - 0.27 Units are factory charged for 15 ti(4.6 m)of 3!8"liquid line. The factory charge for 3/8"lineset 9 oz. When using other length or diameter liquid lines,charge adjustments are required per the chart above. Chatyinu Formula: I(Lineset oz/ft x total length)—(factory charge for lineset))=charge adjustment Example 1:System has 15 ft of line set using existing 1/4"liquid line. What charge adjustment is required' Formula: (.27 o7/ft x 1 Sft)—(9 oz)=(4.95)oz. Net result is to remove 4.95 oz of refrigerant from the system Example 2: System has 45 ft of existing 5/16"liquid line.What is the charge adjustment" Formula: (.40 oz/ft.x 45ft)—(9 oz.)=9 oz. Net result is to add 9 oz of refrigerant to the system LONG LINE APPLICATIONS An application is considered Long Line. \\hen the refrigerant level in the system requires the use of accessories to maintain acceptable refrigerant management for systems reliability. See Accessory Usage Guideline table for required accessories. Defining a system as long line depends on the liquid line diameter.actual length of the tubing.and vertical separation between the indoor and outdoor units. For Air Conditioner systems,the chart below shows when an application is considered Long Line. AC WITH PURON®REFRIGERANT LONG LINE DESCRIPTION ft(m) Beyond these lengths,long line accessories are required Liquid Line Size Units On Same Level Outdoor Below Indoor Outdoor Above Indoor 1/4 175(53.3 No accessories needed within allowed No accessories needed within allowed ) lengths lengths 5/16 120(36.6) 50(15.2) 120(36.6) 3/8 80(24.4) 35(10.7) 80(24.4) Note: See Long Line Guideline for details VAPOR LINE SIZING AND COOLING CAPACITY LOSS Acceptable vapor line diameters provide adequate oil return to the compressor while avoiding excessive capacity loss. The suction line diameters shown in the chart belpw are acceptable for AC systems with Puron refrigerant: Unit Maximum Vapor Line Cooling Capacity Loss Nominal Liquid Line Diameters Total Equivalent Line Length R.(m) Size(Stuh) Diameters (in. 26-SO 51-90 81-100 101-126 126-150 151-17s 176-200 201-226 226-250 (in.OD) (7.9-15.2) 16.6-24.4) (24.7-30.5) (30.8-36.1) (38.4-45.7) 46.0-53.3) (53.6-61.0) (61.3-68.6) 68.9-76.2) 1 tt000 1/2 1 2 3 5 6 7 8 9 11 1 Stage AC with 3/8 5/8 0 1 1 1 2 2 2 3 3 Puron 1 3/4 0 0 1 0 0 1 1 1 1 1 1 24000 518 0 1 2 2 3 3 4 5 5 1 stage 3/8 3/4 0 0 1 1 1 1 1 2 2 wi th lth Pu an 7/8 0 0 0 0 0 1 1 1 1 1 30000 5/8 1 2 3 3 4 5 6 7 8 1 Stage AC with 3/8 3/4 0 0 1 1 1 2 2 2 3 Puron 7/8 0 0 0 0 1 1 1 1 1 36000 5/8 1 2 4 5 6 8 9 10 12 1 Stage AC with 3/8 3/4 0 1 1 2 2 3 3 4 4 Puron 7/8 0 0 0 1 1 1 1 2 2 42000 314 0 1 2 2 3 4 4 5 6 1 Swag AC withh 3/8 7/8 0 0 1 1 1 2 2 2 3 Puron 11/8 0 0 0 0 0 0 0 0 0 48000 3/4 0 1 2 3 4 5 5 6 7 1 Stage AC with 3/8 7/8 0 0 1 1 2 2 2 3 3 Puron 11/8 0 0 0 0 0 0 0 1 1 60000 314 1 2 4 5 6 7 9 10 11 I Stage AC with 318 7/8 0 1 2 2 3 1 4 4 5 5 Puron 1 116 0 0 —0 1 1 1 1 1 1 Applications in this area may be long line and may have height restrictions. See the Residential Piping and Long Line Guideline. -1 ACCESSORY THERMOSTATS PART NUMBER PROGRAM GAS ELECTRIC HEAT PUMP HYBRID HEATHEAT COOL Performance TP—PRH01—A 7—Day J J J J 3 2 TP—PAC01 7—Day J J 1 1 TP—NRH01—A NP J J J J 3 2 TP—NAC01 NP 1 1 THERMOSTAT ACCESSORIES PART NUMBER BRIEF DESCRIPTION THERMOSTATS USED WITH _ SYSTXCCRRS01 Indoor Remote Room Temperature Sensor _ All TP—thermostats _ TP—EXP01—A ExP Computer Programming Accessory TP—P thermostats TSTATXXCNV10t Thermostat Conversion Kit(4 to 5 wire)—10 pack All Carrier branded thermostats TX—LBP01 Large Decorative Back ate TP—Pxx,TP—Nxx,TC—Pxx TSTATXXSEN01—B- Outdoor Air Temperature Sensor All TP—thermostats ACCESSORIES KIT NUMBER DESCRIPTION •18-30 24-30 30-30 36-30 42-30 48-30 60-30 KAAFT0101AAA FREEZE THERMOSTAT X X X X X X X KAATD0101TDR TIME DELAY RELAY X X X X X X X KSALA0301410 LOW AMBIENT PSW X X X X X X X KSALA0601AAA MOTORMASTER 230V X X X X X X X HC32GE234 MOTOR FAN BALL BEARING X HC34GE240 MOTOR FAN BALL BEARING X X HC32GE229 MOTOR FAN BALL BEARING X HC38GE228 MOTOR FAN BALL BEARING X HC40GE228 MOTOR FAN BALL BEARING X X KSAHS1701AAA HARD START(CAP/RELAY) X X X X X X X KSACY0101AAA CYCLE PROTECTOR X X X X X X X KSASF0101AAA SUPPORT FEET X X X X X X X KAACS0201PTC START ASSIST PTC X X X X X X X KAALS020ILLS LIQUID LINE SOLENOID X X X X X X X KAAWS0101AAA WINTER START X X X X X X X KAACH1701AAA CRANKCASE HTR X X X X KAACH1601AAA CRANKCASE HTR X S S KSATX0201PUR TXV PURON HSO X X X KSATX0301PUR TXV PURON HSO X KSATX0401PUR TXV PURON HSO X KSATX0501PUR TXV PURON HSO X X t Required accessories include ball bearing fan motor,compressor start assist(CAP/Relay).crankcase heater.evaporator freeze stet,hard shut—off TXV. X=Accessory/S—Standard ACCESSORY USAGE GUIDELINE REQUIRED FOR LOW-AMBI- REQUIRED FOR LONG REQUIRED FOR ACCESSORY ENT COOLING APPLICATIONS LINE SEA COAST (Below 55`F/12.8'C) APPLICATIONS* APPLICATIONS (Over 80 ft./24.38 m) (Within 2 miles/3.22 km) Ball Bearing Fan Motor Yest No No Compressor Start Assist Capacitor and Relay Yes Yes No Crankcase Heater Yes Yes No Evaporator Freeze Thermostat Yes No No Hard Shut-Off TXV Yes Yes Yes Liquid Line Solenoid Valve No No No Motor Master Control or Yes No No Low-ambient Pressure Switch Support Feet Recommended No Recommended Winter Start Control Yes No No For tubing line sets between 80 and 200 ft.(24.38 and 60.96 m) and/or 20 ft.(6.09 m)vertical differential.refer to Residential Split-System Longline Application Guideline. t Required for Low—Ambient Controller(full modulation feature)MotorMaster`-Control. Accessory Description and Usage (Listed Alphabetically) 1.Ball-Bearing Fan Motor 5. Cycle Protector A fan motor with hall hearings which permits speed reduction The cycle protector is designed to prevent compressor short while maintaining bearing lubrication. cycling. This control provides an approximate 5-minute delay Usage Guideline: after power to the compressor has been interrupted for any Required on all units when MotorMaster-T is used. reason.including power outage,protector control trip,thermostat 2.Compressor Start Assist-Capacitor and Relay jiggling,or normal cycling. Start capacitor and relay gives a "hard" boost to compressor 6.Evaporator Freeze Thermostat motor at each start up. An SPST temperature-actuated switch that stops unit operation Usage Guideline: when evaporator reaches freeze-up conditions. Required for reciprocating compressors in the Usage Guideline: following applications: Required when low ambient kit has been added. Long line 7.Low-Ambient Pressure Switch Kit Low ambient cooling A long life pressure switch which is mounted to outdoor unit service valve. It is designed to cycle the outdoor fan motor in Hard shut off expansion valve on indoor coil order to maintain head pressure witpin normal operating limits Liquid line solenoid on indoor coil (approximately 100 psig to 225 prig). The control will maintain Required for single-phase scroll compressors in the working head pressure at low-ambient temperatures down to W F following applications: (-18'C)when properly installed. Long line Usage Guideline: Low ambient cooling A Low-Ambient Pressure Switch or MotorMasterIF Suggested for all compressors in areas with a history of Low-Ambient Controller must be used when cooling operation is low voltage problems. used at outdoor temperatures below 55'F(I2.8'C). 3.Compressor Start Assist—PTC Type 8.MotorMastere I.ow-Ambient Controller Solid state electrical device which gives a -soft" boost to the A fan-speed control device activated by a temperature sensor. compressor at each start-up. designed to control condenser fan motor speed in response to the Usage Guideline: saturated, condensing temperature during operation in cooling mode only. For outdoor temperatures down to-20`F(-28.9'C), Suggested in installations with marginal power supply. it maintains condensing temperature at 100'F±10'F(37.8'C ± 4.Crankcase Ileater 5.5'C). An electric resistance heater which mounts to the base of the Usage Guideline: compressor to keep the lubricant warm during off cycles. A MotorMaster© Low Ambient Controller or Improves compressor lubrication on restart and minimizes the Low-Ambient Pressure Switch must be used when chance of liquid slugging. cooling operation is used at outdoor temperatures Usage Guideline: below 55'F(I2.8'C). Required in low ambient cooling applications. Suggested for all commercial applications. Required in long line applications. 9.Outdoor Air Temperature Sensor Suggested in all commercial applications. Designed for use with Carrier Thermostats listed in this publication. This device enables the thermostat to display the outdoor temperature.This device also is required to enable special thermostat features such as auxiliary heat lock out. Usage Guideline: Suggested for all Carrier thermostats listed in this publication. 6 Accessory Description and Usage(Listed Alphabetically) (Continued) . 10.Support Feet 12.Time-Delay Relay Four stick-on plastic feet that raise the unit 4 in. (101.6 mm) An SPST delay relay which briefly continues operation of indoor above the mounting pad.This allows sand,dirt,and other debris blower motor to provide additional cooling after the compressor to be flushed from the unit base,minimizing corrosion. cycles off. Usage Guideline: NOTE: Most indoor unit controls include this feature. For those Suggested in the following applications: that do not,use the guideline below. Coastal installations. Usage Guideline: Windy areas or where debris is normally circulating. For improved efficiency ratings for certain Rooftop installations. combinations of indoor and outdoor units.Refer to For improved sound ratings. AtIRI Unitary Directon. 11.Thermostatic Expansion Valve(TXV) 13. Winter Start Control A modulating flow-control valve which meters refrigerant liquid This control is designed to alleviate nuisance opening of the flow rate into the evaporator in response to the superheat of the low-pressure switch by bypassing it for the first 3 minutes of operation. refrigerant gas leaving the evaporator. Kit includes valve, adapter tubes, and external equalizer tube. Hard shut off types are available. NOTE: When using a hard shut off TXV with single phase reciprocating compressors, a Compressor Start Assist Capacitor and Relay is required. Usage Guideline: Required to achieve AHRI ratings in certain equipment combinations. Refer to combination ratings. Hard shut off TXV or LLS required in air conditioner long line applications. Required for use on all zoning systems. 7 ELECTRICAL DATA • OPER VOLTS" COMPR FAN MIN MIN MAX MAX MAX FUSE" WIRE LENGTH LENGTH UNIT SIZE ViPH MCA SIZEt SIZEt ft.(m)t ft.(m)t orrCCKT MAX MIN LRA RLA FLA 60`C 75°C 60°C 75'C AMPS 18-30 48.0 9.0 0.50 11.8 14 14 67(20.4) 64(19.5) 20 24-30 58.3 13.5 0.70 17.6 14 14 46(14.0) 43(13..1) 25 30-30 64.0 12.8 0.70 16.7 14 14 44(13.4) 41 (12.5) 25 36-30 208/230 1-60 253 197 77.0 14.1 0.50 18.1 12 12 57(17.4 54(16.5) 30 42-30 112.0 17.9 1.20 23.6 10 10 85(25.9) 81 (24.7) 40 48-30 -- 109.0 19.9 1.20 -26.1 10 1 10 70(21.3) 67(20.4) 40 60-30 135.0 21.4 1.20 28.0 8 10 91 (27.7) 56(17.1) 40 •Permissible limits of the voltage range at which the unit will operate satisfactorily t H wire is applied at ambient greater than 30°C,consult table 310-16 of the NEC(NFPA 70). The ampacity of non-metallic-sheathed cable(NM),trade name ROMEX,shall be that of 6WC conditions,per the NEC(NFPA 70)Article 336-26.If other than uncoated(no-plated).60 or 751C insulation,copper wire(solid wire for 10 AWG or smaller,stranded wire for larger than 10 AWG)is used,consult applicable tables of the NEC(NFPA 70). t Length shown is as measured one way along wire path between unit and service panel for voltage drop not to exceed 2%. "Time-Delay fuse. FLA -Full Load Amps LRA -Locked Rotor Amps MCA -Minimum Circuit Amps RLA -Rated Load Amps NOTE:Control circuit is 24-V on all units and requires extemal power source. Copper wire must be used from service disconnect to unit. All motors/compressors contain internal overload protection. Complies with 2010 requirements of ASHRAE Standards 90.1 A-WEIGHTED SOUND POWER LEVEL (dBA) Unit Size- Standard TYPICAL OCTAVE BAND SPECTRUM(dBA without tone adjustment) Voltage,Series Rating(dBA) 125 250 Soo 1000 2000 4000 8000 18-30 73 49.5 58.5 64.5 69.0 63.0 59.5 52.4 24-30 74 54.5 62.0 67.0 71.5 66.0 62.0 53.0 30-30 74 56.0 62.5 66.0 68.5 64.5 61.0 53.5 36-30 72 52.0 61.0 64.0 66.0 61.0 58.5 51.5 42-30 1 74 1 56.5 61.5 65.0 66.5 63.5 61.0 56.5 48-30 73 58.0 1 61.0 65.0 66.0 1 62.0 58.0 51.0 60-30 74 56.5 _6_2.5 86.5 68.0 63.0 59.5 51.5 NOTE: Tested in accordance with AHRI Standard 270-08(not listed in AHRI). CHARGING SUBCOOLING (TXV-TYPE EXPANSION DEVICE)_, UNIT SIZE-VOLTAGE,SERIES REQUIRED SUBCOOLING'F "C) 18-30 10(5.6) 24-30 - - 10(5.6) 30-30 10(5.6) 36-30 10(5.6) 42-30 9(5.0) 48-30 10(5.6) 60-30 9(5.0) 8 i n v`v 4x�•K4= opn�v w ,e r ".qt ]�'•_.. � _- r.: J J tp k rJ- J.•}•t?t y r:✓`>ti J r.- � �.3° C r A _.. �VJ �,f/A- h r t .� A A t -:A t�r.,_ y�i'F •7: Y �'',, `��,y] . 3 �. _.�,4,Yri���'7 + ii!•��'.''��,r .y 'rll'1(n.c xr p'';0yS4;'t' :•o Q..l,�irrrti r», D +'4�"i i, O �r. tl�'+ r .. O li �'. 4'4!.�'•,1 f l 1 {nth{I? �i++�'kM ^{''11`" �`K si. - Y- .:;R S!>a,}y f o• { -:.t„,„7..1.....5 a l:c,, t�,Ilvuu�N A,y"V. '.IfR�ly1!�.,ifs;f.,.e v M Al., ,,1;•fY.' �... ,7 n Ji t:t v. 'w �C .r'j�' �. P' v . .�'�� J It���.`_.,.• Jet, v. e4.ly� • +�5;7.i. ar n44+ - kirr�� a t F):,' •. 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RYatrooa A '-3573 CG fMt-MIA ACORD CCWdK""M M Mole aaARRrad ACCOW n peTM31 TUN ACGRD Ram.and Ingo am"stn+we nwvkm of ACCM STATE.(W VEW YORK WORKERS'CCkMPENSATICA DUARU CFRTIFICATE OF NYS WORKERS' COMPENSATION MURAINCE COVERAGE I■.Lapl Name A Addrtas of inured(Lse street aMrew only? I b.Bwsiaesa Toaapbnne Numabar of Itasi red Stevie Ar, Inc 518-642-2579 PO Box 337 it.NN'S L'ammpisymest Insurance Lmpio%vr Mi"a Granvie, NY 12B49 "IstnMon Mrmber of Insured W*rbtoemtiaref1marred(Gnbnayw4difCVWepelisPMc"c*b Id,FedeniEaispivyyerld•nlrfirsti"nNnrber61lowered AMarte/M ate"M faats9 4 M Orr, ►ark S.saar, i.e., a 0'np4p or Switil Scsiprity 14umbrr loJtryl 201521920 2.Name and Address of the Entity Requtottag Proof of 3a Name of Inarranta Uatritr C'eherW(Entity Being LWW as the Cmiitlirste Hddrri Erie Insurance Go Ryebrcok goading Dcpt 3b.Peiey Number of entity Nsted in Wit'in" 9M King Sifeet 092-8000136 Ryebovok, NY 10573 3c. 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Pkasa N'oaa_Upon abe cancnilatlon of the worben'tmspea mtim paUq iodkated on this forts,it the bwsasess continues to be named on a permit.license or rontrart mg;PW by a rwrtirrcaar holler,for bu*kwss marl prwsida that csrti%mt holder wick a new Certlfleste of Worker'Compcwsadon Coverage or other strthoriaM rr W M business at the is twwplring with I]**eassdaaory arc orage rtqulrttststs of the New York Statx N'orktrs'CompmsaMn Lan. l ender penalty of perjory.I cerlif-thal 1 no an authorised rnprtowatatire or lkvnsad agent of the insunnee carrier rc/erem.ctd above and that the named insured has the colvrage as depoded on this f*rm, ,tpprev,ed by Lisa Lamb ttrrw,����emvr rr lonwod Mwr of ws+aan srrl AppfOYed by -- -- _� t wamtari Pam► rlt. Agent Ul pisaM NuasbsrofssNhtriaod rsOrsasntmtive.+liucnsed spent of intarwtes carrier 316 f4Id1J6 Ileow Nex Aab mau-&Kv cwrxn aAd/heir lxemed allovs air awhortred to.nut Form C-145: lnswwwr br-AM NT'40T PiMtg wo r4 Aran►R C•IUS2l'WF weir wcl.%UIr ny M