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HomeMy WebLinkAboutMP23-007 QyE aR 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 ACTING BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE March 15,2023 Thomas Potter&Ellen Potter 16 Beechwood Boulevard Rye Brook,New York 10573 Re: 16 Beechwood Boulevard, Rye Brook,New York 10573 Parcel ID#: 136.29-1-7 This document certifies that the work done under Mechanical Permit #23-007 issued on 1/17/2023 for the installation of a new gas fired boiler has been satisfactorily completed. Sincerely, Steven E. Fews Acting Building&Fire Inspector /to �E BRC�v� 1982 BUILDING DEPARTMENT ,,t❑BUILDING INSPECTOR �J 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:— '�/? —�"''^+-�LJ l( _ .3\ DATE: PERMIT# ) .� P ) ISSUED: ,'``` OJECT: BLOCK: LOT: .-� b LOCATION: ` l � " ` / OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... Q 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 Ei p, r�x 771 y45 nib oaww �p., +1 � W \ �! p q p p y on Q 0 � ob H MM w o = a � Q _ � �� .� � u !y fi! y N O ~' p C II�1 Q [T co o Fri a' 4Piovov , V 011% wz � � av ON �j� M 0 cn o VCP, d- 5 ° W x E pm oIx H � 0-4 F•i a v � Ao p O p = V r o M S b I,: u �--� C7 Z q av' ya•; o E.y p � W A O �" •� '�xa >' - � A H W Z p�, o � •� •� o � =1 141 pol >41 Wol x � � � b U CIE WE E BU1LDjNC`,,d90ARTMENT JAN 13 2023 Vu. n ti O)F RYI tAAOOK VILLAGE OF RYE BROOK 938 KINGS-hip:I RYE.HR()dk,NY I01-73 BUILDING DEPARTMENT (�14) -066S —.._-- -- w c. �r APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTII.A I ION AND/OR AIR CONDITIONING FOuIPMENT FOR(lIIR I I til ()NI ) PLRMPI t /- c>)3--07 Approval Date: AN 1A Permit Fee:$ - „a Approval Signature: UL Other. Disapproved: (ree,rrc�,-reruadanre) arrtatttrtittttrwrwtwrrtaaawtttwwwwtwwttrrrrrtw*rwrrrrtrrrrrrrtier*a*rtrwtt+ttrrrrrrrrrrrrrrrrwww►rwrrrr Rt:Ot;IREMENy%FOR REI.EASE OF PERMIT&CF.RTIFICAT E OF COMPLIAAtCE; I. Properly completed& Signed Application. 2. Site/Staging Ilan if Required by the Building Inspector. 3. Copy of L.iccn,ed Contractor's Liability Insurance.(Village of Rye Brook maw be lisaed as ccrtiricatc holdco&Workers Compensation Insurance on a NYS Board form(Form#C145.2 or Form#U26.3/or NY state Workers Compensation waivcr) 4. Payment of Fees/Unit:RFSIDEN11AL.-SI00.00/unit-COA�iFRCIAL d S34YA ni)<<r< 5. Inspection by the Building Department for removal and/or installation.(4&1errrrro6re reg91rW 6. Electrical work requires a separate Electrical Permit&Electrical fnspcctj'on., n 7. PtumbbWGas work requires a separate Plumbing Permit&Plumbing Inspection. =� aaaaaaiaiiii iiiiiataiaaaaiiitaiiiiaiaaaaiiiaiitaaiaaasat#atraiiaiaiiatiiaiaaiaiisaaitaiiatiia Applieatinn dated li/3 is herrby made to the Building Inspector of the Village of Rye Brook for a permit for the installaricm and or removal of the I1VAC 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: 16 BEECHWOQD Boulevard SBL: �3�Pz�9 -7 zone:/C- c 2. Property Owner: Ellen M Potter Address: 16 BEECHWOOD Boulevard Phone#: 914-261-6721 cell r.:_914-261-6721 email:ellenm tter@g.mail&gm 3. Contractor: Arctic Mechanical _ Address:460 North Main Street, Port Chester, NY Phone#: 941-934-8301 Cell#:914-830-9318 email:bravo'rC�arctic-mechanicat.corrt 4. Applicant: Jhonny Bravo Address: 460 North Main Street, Port Chester,NY Phone#: 914-830-9318 Cell#: 914-830-9318 email: bravo'r@arctic-mechanical.eom 5. Scope of Work:New Installation( )•Rcplaciernent 0-Removal( )•Other 6. List Equipment: Utica MAHF-165 Boiler 7. Location of Lquipment: In basement mechanical room 8. Method of Installation/Removal(hst all tWipm n,needed to perform job): f i t i lLI1.a'!9 STAIT OF NEW YORK.COUNTY OF wriswilESTT111 ) as: Jhonny Bravo .being duty sworn,deptises and states that he/she is the applicant above named, (print name of indn'alual ugmng as the applicant) and further states that Whe is the legal owner of tic property to which this application pertains,or that(s)he is the Contractor far the legal owner and is duly authorized to make and file this application. ondicate aminleet,contractor,agent atimney,etc.) 'lliat all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at die above captioned property will he 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 106, Sworn to before me this day of 0 vio I afA20 13 day ofJaAUaX—tI 20 dA Signat of Property Owner Signature of Applicant S �onf►y 6ta V 6 Print Name ol Property Owner PAotary i of Applicant Notary Public --- Pultkha Whalen ALAN H 86LARz Public,State of Ne-W`ArkMoMMYPublic-State of Now writNo.01 WHS394580 No.o2SSW Qualified in Westchester Cottrtty CunnmIssion� ebn*st r County Chm Sion to tfYYtpet Commission Expires July 8,2023 Y 24,2026 This application must be properly completed in its entirety and must include the notarized signature(s)of the legal o%ver(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 9112J2021 UTIC4 BOILERS Utica Boilers MAHF-165 - Submittal Engineer: Project Name: Project Location: x Contractor: -Y ®'' CPO (&a ME US H �R A APPLICATION: Modulating Gas fired water boiler for indoor installation. Approved for closet or alcove installations. For use with natural or liquefied petroleum (LP/Propane) fuel gases. Boiler shall be floor standing. All boilers are factory assembled with controls and wiring and test fired to ensure dependable performance. Boiler shall be certified for Direct Vent applications only. CERTIFICATION AND APPROVALS: Stainless Steel heat exchanger is manufactured and tested in accordance with American Society of Mechanical Engineers (ASME) and certified by Canadian Standards Association (CSA), AHRI, NRCAN. Registered with National Board BPVI, and Massachusetts Board. Stainless steel heat exchanger is tested for maximum allowable working pressure of 50 psig in accordance with ASME boiler and pressure vessel code, section IV, rules for construction of heating boilers. A 30 psig safety relief valve is shipped standard. BOILERS INCLUDE: • Boiler includes factory installed and wired, electronically controlled, 2 step modulating circulator pump. The circulator RPM is determined by the boiler temperature and controlled by the integrated boiler control. • Primary/Secondary manifold with quick connections installed on the boiler. • Digital Boiler Control: ► Control is self-commissioning, automatically recognizing fuel type (Natural or LP gas). Control continuously monitors flame signal and automatically adjusts the gas valve during normal operation for optimum combustion and maximum efficiency. ► Control system is PCB integral controller with LCD digital/graphical display. ► Control can sense and display water temperature and indicate when boiler is in central heating or domestic water mode. No, Control can accept an optional Outdoor Air sensor and has field adjustable reset curves. ► Control displays Error Codes and Diagnostic information. ► Control can accept 0-10V input to manage heating set-point or heating power level. CO- ) ECR international Manufactured by: ECR International Inc. 2201 Dwyer Avenue,Utica,NV 13501 Tel.800 325 5479 www.ecrinternational.com PN 615000350 REV.D[10/15/20211 9 UTIC4 BOILERS • Boiler Combustion System: ► The Gas valve is a modulating valve capable of firing from 164,000 BTU input down to 29,500 BTU input in Heat mode (5.5:1 turn down). ► Induced draft blower is variable speed controlled by the PCB. ► Burner is constructed of Iron-Chromium stainless steel. ► Ignition system shall incorporate a Direct Spark Igniter and a separate Flame Sensing rod. • Heat Exchanger: No, Boiler's primary heat exchanger is constructed of Iron-Chromium stainless steel. • Electrical ► 120 volts AC, 60 Hertz, 1-phase; less than 15 amps. ► Low voltage terminal strip for Thermostat, Outdoor Air Sensor, Indirect Tank sensor. • Warranty ► Factory Standard Limited Warranty is 10 years on heat exchanger, one year on parts. ► Please see the Limited Warranty for More Detail on Warranty Registrations & Extensions. • Optional Equipment ► Outdoor Air Sensor Kit ► Indirect Tank Sensor Kit ► Coaxial and Two-pipe venting components CO) ECR international Manufactured by: ECR International Inc. 2201 Dwyer Avenue,Utica,NY 13501 Tel.800 325 5479 www.ecrinternational.com PN 615000350 REV.D t10/15/20211 UTICA BOILERS CERTIFIED Boiler Input Rate(MBH)I'I Heating Capacity Net AHRI Rating, al Size (MBH)i'lizl Water(MBH) AFUE Maximum Minimum MAHF-165 164 19.5 153 133 95.0 (01000 Btu/hr(British Thermal Units Per Hour) (z)Heating Capacity and AFUE (Annual Fuel Utilization Efficiency) are based on DOE (Department of Energy) test procedures. (3)Net AHRI Ratings based on piping and pickup allowance of 1.15. Contact Technical Support before selecting boiler for installations having unusual piping and pickup requirements, such as intermittent system operation, extensive piping systems, etc. *Max CH Supply temp 1761 F (80°C)for MAHF-165 *Max DHW temp 1401 F(601 Q MAHF-165 Minimum Clearances for Servicing Top 8.66 in / 220.00 mm Bottom 9.84 in / 250.00 mm Sides 1.77 in / 45.00 mm Front 17.71 in / 450.00 mm Flue Terminal Size Concentric System 3.93 in / 100.00 mm Flue Terminal Size 2-Pipe Flue System 3.14 in /80.00 mm Flue Terminal Protruding 4.52 in / 115.00 mm MAHF-165 Central Heating (Sealed System) Max System Pressure 43.00 psi / 2.96 bar Min System Pressure 7.25 psi / 0.50 bar Max System Temperature 176°F/ 800C Pressure Relief Valve Setting 30.00 psi / 2.11 bar Flow Connection 1.5"/38.1 mm Sweat Return Connection 1.5"/38.1 mm Sweat Relief Valve Connection 3/4"/22.2 mm NPT Recommended Operating System 21.7 psi / 1.5 bar Pressure MAHF-165 Weight 168 LBS / 76.2 kg CA) ECR international Manufactured by: ECR International Inc. 2201 Dwyer Avenue,Utica,NY 13501 Tel.800 325 5479 www.ecrinternational.com PN 615000350 REV.D[10/15/20211 uTICA BOILERS Width 18.56" -- 1 in U� rh N 0 L View - Front of Boiler a' G orn u7 N L p1 a) 2 f 1 ECR international Manufactured by: ECR International Inc. 2201 Dwyer Avenue,Utica,NY 13501 Tel.800 325 5479 www.ecrinternational.com PN 615000350 REV.D[10/15/20211 UTIQ BOILERS Venting Coaxial Venting Connects directly to the top of the boiler 2-Pipe Venting - Optional Kit Using polypropylene - 80 mm venting 2-Pipe Venting - Optional Kit Using CPVC UL1738/S626 - 3"/ 80 mm venting t Total Vent Equivalent Lengths* - Account For Fittings As Listed Twin Pipe Coaxial Rigid Flexible CPVC UL1738/ S636 Vent Size 4"/2" 3" 2" ** 3" 3" [100/60] [80 mm] [60 mm] [80 mm] [80 mm] Total Maximum 32.8 ft [10 m] Air Intake Maximum 49 ft 85 ft 50 ft 49 ft [15 m] [25.9 m] [15.2 m] [15 m] Intake + Exhaust 196.8 ft 170 ft 130 ft 196.8 ft [60 m] [51.8 m] [40 m] [60 m] 900 elbows 3.28 ft 1.64ft 3 ft 1.64ft 1.64 ft [1.0 m] [0.50 m] [0.91 m] [0.50 m] [0.50 m] 450 elbows 1.64 ft 0.82 ft 5 ft 0.82 ft 0.82 ft [0.50 m] [0.25 m] [1.5 m] [0.25m] [0.25 m] * Refer to IOM for complete venting details. ** Use venting manufacturer's components to transition from 3" [80 mm] to 2" [60 mm] CO) ECR international 2201 Dwyer Avenue,Utica,NY 13501 All specifications subject to change without notice. Tel.800 325 5479 ©2021 ECR International,Inc. www.ecrinternational.com '1 A`OR" CERTIFICATE OF LIABILITY INSURANCE �TEIMriI 12/Z02021 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate Holder is an ADDITIONAL INSURED, the policy(ies) nest have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, slbiect to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does rot confer notits to the certificate holder In lieu of such erWorsertlent s PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME: --CUENT CONTACT HOME OFFICE:P.O.BOX 328 A/CNNo,Eel:US 333 4949 F :5074464664 OWATONNA,MN 55060 E•MAHL T INSURIRIS)AFFOROMG COVERAGE NAIL x MSU*ER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 2864684 INSURER 9:FEDERATED RESERVE INSURANCE COMPANY 16024 ARCTIC MECHANICAL INCORPORATED INSURER C: 460 N MAIN ST PORT CHESTER, NY 10573-3310 INSURER O: INSURER E: INSURER F: _--- ---- _.. OOVERAOES CERTIFICATE NUMBER 90 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 DEICUMENI 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 ADDL UBR POLICY NUMBER POLICY EFF POLICY EXP YVIINEMoftlyyr uNTS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR AGE TO RENT PR M(sE3 a ocarErenLe1 --. $100,000 MED EXP(Ally orr parson) EXCLUDED A N N 9907993 01/18/2022 01/181=3 -PERSONAL AADVINJURY $110MAW AGORtOM LIMIT APPLIES PER: GENERAL AOOREOATE X POLIC PRO-JECT ��LOC '. ��'� PRODUCTS.COMPIOP AGO $2,000,000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT =1,0w,0w X ANY AUTO IEI1lf'45IMI INJURY INRY(Per Pon) A OWNED AUTOS ONLY SCHEDULED _ Autos N N 9901993 01/18/2022 01/18/2023 eoalrlNJURY(ParaeelAntO I HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAOE lEor addend X UMBRELLA LIAR X occult EACH OCCURRENCE $510001000 A EXCESS LIAO CLAIMS wm N N 9907994 01/18.2022 01/18/2023 AOOREGATE $510001000 DED X RETENTION S10.000 WORKERS COMPENSATION Y/N X PER STATVfE ER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNE R/EXECUTIVE E.L.EACH ACCIDENT B OFFERIMEMBER EXCLUDED' N I A N 9298530 01/18/2022 01/18/2023 $1,000,000 X: IMatANory In NH) E.L.DISEASE•EA EMPLOYEE $1 0w 000 If yea,describe Infer DESCRIPTION OF OPERATIONS below E.L DISEASE.POLICY LIMIT $110001000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101 Addlsortal Remarks Schedle.may be attached it more space Is reQwredl CERTIFICATE HOLDER CANCELLATION 286.468.4 900 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 (0 1966-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered rants of ACORD YORK Workers' CERTIFICATE OF TE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured ARCTIC MECHANICAL INCORPORATED 914-934-8301 460 N MAIN ST PORT CHESTER,NY 10573-3310 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limrted to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-lip Pb/icy) Number 06-1596446 2.Name and Address of Entity Requesting Prod of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Federated Reserve Insurance Company Village of Rye Brook Cert 90 3b.Policy Number ofE 938 King St 929P530 Entity listed in Box"I a" Rye Brock NY 10573-1226 3c.Policy effective period 01118(2022 to 01/1 8202 3 3d.The Proprietor,Partners or Executive Officers are X❑ included.(Only check box if all partners/othcers included) EJ all excluded or certain partnersiolficers oxckuded. This oanifies ttlat the insurance carrier indicated above in box 'T'insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this fam,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance poI 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 at premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mad.)Otherwise,this Certificate is valid for one year after this forth 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 nghts 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 poky 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,)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. Approvod by: Theresa A Riecke (Pent name of authonzed rgxeawtt bye of licerual agent of in"arxe carrier) Approved by: 12013M 1 signature? (pare) 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 NQT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov