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HomeMy WebLinkAboutFire Inspection Certificate 2023-2026 Ln O G w r�1 � .� ^O •� F v �G� ON CN cn wCN F Ln o 0 A � O � � u � z W (� Cl) O >1 o - co 45. 'CIO CO) " ►� H UX H Q w z j �BRa��. • 1982 BUILDING DEPARTMENT 10UILDING 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.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: '!- t` '�- 1JATE: l('n' PERMIT# ` n!��ISSUED: ` V - JEC�Tl: BLOCK: LOT: LOCATION: ` •� • V 1 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 J;KFINAL ❑ OTHER s., BUILD TMENT VILL OF tROO OOK Initial Inspection Date: ❑ Pass MICHAEL J.Izzo 938 KING ST RYE , Ew YORK 10573 S I Fail BUILDING&FIRE INSPECTOR (914)9 w rook.or Re-Inspection Date: ❑ Pass mizzo@rvebrook.ors ❑ Fail FIRE INSPECTION REPORT,NOTICE OF VIOLATION & ORDER TO REMEDY SAME Site Address: 20 1 A elc Zone:C! SBL: Occupancy: �� t State Use ,`Classification: Business Owner: Building Owner: Phone: Emergency Contact: Phone: S �-�• �(� �� Building Representative in Attendance: Take notice that the following violations of the N York S e Uniform Fire Prevention& ilding Code and/or the Code of the Village of Rye Brook were f nd to exist at, c , ci ,in the Village of Rye Brook,NY on, 2077Z The person or e6dty served with this Order to Remedy shall r immediately cogimepcce^tto correct all listed violations ands 1 completely cure each violation described herein by no later than �► which is thirty(30)days after the date of this Order to Remedy.Furthermore, upon curing any listed violation(s),you shall immediately contact the Building Department during normal business hours to schedule a re-inspection of the premises to confirm full compliance with all applicable codes,laws,rules&regulations. BE ADVISED THAT YOUR FAILURE TO CORRECT ALL VIOLATIONS IS A CRIME PUNISHABLE BY FINE,IMPRISONMENT OR BOTH. ------------------------------------------------------------------------------------------------------------------------------------------------------------------ No YES N/A 1._PORTABLE FIRE ExTINGULSHERS (PFE's) i a.906.1. Are PFE's installed throughout the space&on the premises as required by code. a. b.906.3.1.Is the maximum travel distance to a PFE 75 feet or less. b. c.906.5.Are PFE's conspicuously located&readily accessible. C. d.906.6.Are PFE's unobstructed/unobscured from view. d. e.906.7.Are PFE's properly mounted as per the manufacturers instructions. e. f.906.9.Are PFE's properly installed:<401bs.max.5'above floor;>40 lbs.max.3.5'above floor. f. 2.FIRE ALARM SYSTEM&SMOKE DETECTORS a.901.6.1.Is the fire alarm system inspected,tested&maintained in accordance with NFPA 72. a._ b.907.4.2.1.Are manual pull stations located within 5 feet of exits&within 200 feet of each other. b. c.907.4.2.2.Is the height of the pull station handle located between 42&48 inches above the floor. C._ - d.907.3.Is a fire alarm system provided in existing buildings as per section 907.3.1 &907.3.2. d. 3.FIRE SUPPRESSION SPRINKLER SYSTEM&FIRE HYDRANTS a.901.6.1.Is the sprinkler system inspected,tested&maintained in accordance with NFPA 25-13. a._ 1/ b.901.6.1.Are the main valves secured against tampering in the open position. b. c.901.6.1.Are sufficient clearances maintained from fire sprinkler heads to fixtures or materials. C._ T� d.901.6.1.Is a supply of six spare heads&a wrench maintained on the premises. d. e.901.6.1.Are sprinkler heads&cover plates unfinished or of factory applied finish only. e. f.901.6.3.Are records of all system inspections,tests&maintenance reports maintained on the premises. f. g.913.5.Is the fire pump inspected,tested&maintained in accordance with this section&NFPA 25. g._ _V h.507.5.2.Is the fire hydrant system properly maintained,operational,compatible w/NST&tested annually. h._ _v i.507.5.4.Are fire hydrants&fire protection equipment unobstructed. i._ _✓ _ j.507.5.5.Is a clear space of not less that 3 feet maintained around all hydrants. j._ ✓ k.901.8.Are all fie protection syste laAAND tained untampered. k. INSPECTOR: DATE: C 202 J -- Revised 2110/22 No YES N/A 4._STANDPIPE.CABINETS&FIRE DEPARTMENT CONNECTIONS a.901.6.1.Is the standpipe system inspected,tested&maintained in accordance with NFPA 25-14. a.b.901.6.1.Has the required flow test been performed within the past 5 years as per NFPA 25-14. b. __ _ c.912.2.3 Are standpipe FDC threads compatible with fire department standards. C.d.905.7.Are cabinets containing fire fighting equipment unobstructed/unobscured. d. _ _ _ e.905.7.1.Are cabinets containing fire fighting equipment properly identified&labeled. e. __ _ f.912.2.1.Are exterior FDC's fully visible&recognizable from the point of fire department access. f. _ _ g.912.4.Are all FDC's unobstructed and available for immediate access by the fire department. g. 5.EXITS,MEANS OF EGRESS&OCCUPANCY a. 1031.2.Are exits&exit enclosures continuously maintained free from obstructions or impediments. a. b. 1031.3.Is the means of egress free from obstructions including accumulated ice&snow. b. c. 1031.6.Are exits maintained unobstructed by furnishings,decorations,draperies,mirrors,etc... C. d. 1031.7.Are existing emergency escape&rescue openings maintained as per this section. d. e. 1010.1.Are egress doors provided and maintained as required by this section. e. f. 1004.9.Are all spaces having an assembly occupancy posted with an approved occupant load sign. g. 1013.1.Are exits marked by a properly located,approved&readily visible exit sign. g. h. 1013.1.Is the maximum travel distance to any exit sign in an exit access corridor 100 feet or less. h. _ !/ _ i. 1013.4.Are tactile exit signs complying with ICC/ANSI 117.1.provided as required by code. j. 1013.3.Are all exit signs illuminated at all times. k.1008.1.Are the means of egress&exit discharge illuminated at all times the building is occupied. k. _ y 1. 1018.3.Are public aisles in group B&M occupancies maintained at least 36"wide where fixtures 1. are placed on one side of the aisle&at 44"wide where fixtures are placed on both sides. in. 1018.3.Are non-public/non-accessible aisles serving less than 50 people maintained at least in. 28"wide,or at least 36"wide where serving 50 or more people. 6.COMBUSTIBLE STORAGE&WASTE MATERIALS a.304.1.Is the building(s)and premises maintained free from accumulated combustible waste material. a. b.304.1.2.Is property free from weeds,grass,vines or other growth capable of being ignited. b. c.304.2.Is combustible rubbish stored so as not to create a nuisance or hazard to the public. C. d.315.3.Are combustible materials properly stored&separated from ignition sources. d. !� _ e.315.3.1.Is storage maintained 24"or more below the ceiling in nonsprinklered buildings, e. and 18"or more below sprinkler head deflectors in sprinklered buildings. f.315.3.2.Are exits&exit enclosures maintained free from stored combustible materials. f. g.315.3.3.Are boiler,mechanical&electrical rooms maintained free from stored combustible material. g. h.313.1.Is building maintained free from stored fueled equipment. (motorcycles,mopeds,mowers,etc...) h. 7.ELECTRICAL a.604.1.Is the building free from modified/damaged wiring,devices,appliances,equipment a. and maintained free from electrical hazards. b.604.2.Are electrical service equipment areas properly illuminated. b. c.604.3.Are proper working space clearances provided&maintained for electrical service equipment. C. d.604.3.Are electrical service equipment working spaces free from any stored materials. d. e.604.3.1.Are all electrical control panel room doors,panel boards&disconnects properly labeled. e._ t f.604.4.Is the building free from unfused multi-plug electrical adapters. f. g.604.5.Are electrical extension cords being used in a safe manner as per code. g.4 h. 604.6.Are all junction,switch&outlet boxes fitted with approved covers or plates. h. i.604.6.Is the building free from open-wiring spliced electrical connections. L j.604.8.Are electrical motors maintained free from accumulated oil,dirt&debris. j. k.915.1.Are Carbon Monoxide Detectors ins a maintained as required by this section and by 1103.9. k.V INSPECTOR: DATE: 1 W-DL3 �1\ -2 Revised 6/11/2020 No YES N/A 8.ELEVATORS,DUMBWAITERS&ESCALATORS a.[PM]603.1.Are elevators properly maintained,and is the current certificate of inspection on the premises. a. b.606.3.Are approved standardized,pictorial signs posted adjacent to each elevator call station on all b. floors reading; IN FIRE EMERGENCY,Do NOT USE ELEVATOR,USE EXIT STAIRS c.606.7.Are keys for elevator car doors&fire department service kept in an approved location. C. d.315.3.3.Are elevator machine rooms maintained free from stored combustible material. d. e.[B]3005.1.Are elevator machine room doors maintained unobstructed at all times. e. 9.COMMERCIAL KITCHENS a.906.1. Are portable Class K fire extinguishers installed within 30 feet of cooking equipment. a. b.904.12.5.Is the fire protection equipment inspected,tested&maintained as per Section 901.6. b. _ c.904.12.5.2.Are automatic fire extinguishing systems serviced at least every 6 months. C. d.904.12.5.3.Are fusible links&automatic sprinkler heads replaced annually. d. _ e.[RB]122-5.B.Are grease traps provided and installed as required by Village Code. e. _ f.[[PC]1003.10.DWI 122-6.Are grease traps properly maintained as per State and Village Code. f. _ g.[RB]122-6.C., 122-9.Are all service,maintenance,&repair records for grease traps and related plumbing maintained on the premises as required by Village Code. g. — 10.HEATING SYSTEMS f a. [PM]603.1.Are all heaAg appliances properly installed&maintained in a safe working condition. a. b. [PM]603.2.Are all fuel-burning appliances&equipment connected to an approved chimney or vent. b. c. [PM]603.3.Are heating appliances maintained with proper clearances from combustible material. c. d.[PM]603.4.Are safety controls for fuel-buming equipment maintained in effective operation. d. e. [PM]603.5.Is the fuel-burning equipment provided with adequate combustion&ventilation air. e. [i 11.MOTOR FUEL-DISPENSING FACILITIES&REPAIR GARAGES a.2303.2.Is an approved,labeled&readily accessible emergency disconnect switch provided a. in an approved location within 100'of,but not less than 20'from fuel dispensers. b.2304.3.4.Are dispenser operating instructions conspicuously posted on every fuel dispenser. b. — — c.2304.2.4.Are fuel-dispensers unobstructed&in clear view of the attendant at all times. C. d.2305.5.Are approved portable fire extinguishers complying with Section 906 with a minimum rating of d. — — 2-A:20-B:C provided&located not more than 75' from pumps,dispensers&fill-pipe openings. e.2305.6.Are warning signs provided&posted within sight of each dispenser as per this section. e. f.2305.7.Are weeds and other combustible materials kept at least 10'from fuel-handling equipment. f. _ — g.2306.4.Are above-ground tanks provided with vehicle impact protection. g. — — h.2306.5.Are above-ground tanks provided with secondary spill containment. h. 12.HAZARDOUS MATERIALS(HAZ-MATS) a.407.2.Are S.D.S. Sheets for all haz-mats readily available on the premises. a. — — b.407.3.Are spaces and individual containers containing haz-mats properly labeled&identified. b. — -b-.' — c.5004.2.Are stored haz-mats provided with approved secondary spill containment. C. d.5003.7.I I.Are proper No SMOKING signs provided as per this section. d. 13.MISCELLANEOUS a.403.1.Is an approved fire safety&evacuation plan prepared&maintained for the building/occupancy. a. _ _✓ _ b.405.1.Are emergency evacuation drills conducted at the intervals as specified in Table 405.2. b. — — c.405.5.Are records of emergency evacuation drills kept&maintained on the premises. c. — d.505.1.Are approved address&building numbers properly placed&plainly visible from the street. d. — — e.506.1.Are approved key boxes(knox boxes)provided,properly located&equipped with the proper keys. e. — f.703.1.Is all required fire-resistance rated construction properly maintained as per code. f.)1C g.703.1.Are openings through fire-resistance rated assemblies properly protected&maintained. g. — h.5303.5.Are compressed gas cylinders&systems secured&safeguarded against damage&access. h�e _ i.5303.6.1.Are compressed gas cylinder caps or collars in place at all times except when tanks are in use. i. 14.GENERAL HOUSEKEEPING a.Good b.Fair ' c.Inadequate d.Poor INSPECTOR: DATE: -3- Revised 9/17/2 1 ITEM NUMBER REMARKS c� col v ra E—x U" c <pc 'o C�� 6 cn N S U CSL(D F Cm% 1 c e QYc� 06 , 1 \s V � s�ICX n r Uwe �cr� k ocb v 2Q P - �r K <7�k n SoCU(;Z� Fe- i� C a s '47 INSPECTOR: DATE: f h dZ3 -4- Rcvised 6/11/2020 r ��z ewcl SO(M44 (rEp. C&DrCT Inspection, Testing and Maintenance Form Wet Pipe Fire Sprinkler ALL SAFE Systems FIRE SPRINKLER SYSTEMS INC. This form covers the minimum requirements of NFPA-25 2017 for wet pipe fire sprinkler systems connected to water supplies without tanks or fire pumps.Seperate forms are available for fire pumps,tanks,hose connections,and other fire protection systems.More frequent inspection,testing and maintenance may be necessary depending on the conditions of the occupancy and the water supply Property Name Date of Work Plaza building(4-34 Rye Plaza) _ ] 09/06/2022 Address Phone 24 Rye Ridge Plaza - -- __j 914-701-4005 City stab Zip Code Properly Contact Rye Brook NY 1053 1 Alena Hakanjin Owner Name Win ridge Realty LLC All responses refer to the current work performed on this date. Inspection Type Weekly Monthly Quarterly Semiannual Annual 5-Year Notes 1)All questions are to be anwered Yes,No,or Not Applicable.All'No answers are to be explained in Part III of this form 2)Inspection.Testing,and Maintenance tasks are to be performed with water supplies(including fire pumps)in service,unless the impairment procedures of Chapter 15 of NFPA 25 are followed. PART 1-Owner's Section A.Is the building occupied? B.Has the occupancy and hazard of contents remained the same since the hat inspection? -select an option- 1 C.Are all fire protection systems in service? D.Has the system rereined In service without i nodlfrcation since the Teel inspection? -select an option- -select an option- L Was the system free of actuation of devices and alarms since the last Inspection? -select an option- Owners Representative Dab Alena Hakanjin --- 09/06/2022 Signature r-------------------------------� n r r r h r n r h n h r r n r r r h h r n n r r r PART 2-Inspector's Section A.Inspections-Report any failures in Section III 1.Weekly Inspection Items a.Control Valves(including backflow,presenter isolation valves)supervised with seals passed b.Relief port on RPZ not discharging inspection as descnbed in II-A 2.a)_ N/A Yes - 2-Monthly Inspection items(in addition above items) a.Control Valves and Valves on backflow preventers 1.In correct(open or dosed)position? 2.If not electrically supervised,kxked in correct position? Yes Yes 3.Accessible and free from visible leeks? 4.Provided with appropriate wrenches? Yes ----- -- Yes 5.Provided with appropriate identification? Yes b.Alarm valve free from physical damage,trim In correct(open or eased)position,and no leakage from reta rd ing cha mber or dra In s' Yes 3.Quarterly hispectlon Rams(in addition to above Items) 1of4 a.Gauges monitoring water pressure in good condition and showing normal water supply b.Fire department connections visible,accessible,couplings and swivels not damaged, pressure gaskets in place and in good condition,check valve not leaking,dapper in place and Yes operating properly,and operating drain valve in place and operating properly(if plugs or caps -- -�are not in place,inspect for interior obstructions) [Yes77 c.Control valves electrically supervised d.Alarm and supervisory devices not damaged? yes Ves a.Pressure reducing valve in open position,not leakng,with downstream pressure per design criteria and in good condition with hand wheels not broken? N/A 4.Annual Inspection(in addition to above items) a.Proper number and type of spare sprinklers? 1.List of spare sprinklers attached and legible Yes Yes b.Visible Sprinlders 1.Proper position:Upright,pendent,sidewell? 2.Free of leaks,corrosion,damage? Yes Ves 3.Proper clearance below sprinklers? 4.Free of foreign material including paint? Ves Yes S.Liquid in all gas bulb sprinkles? Yes t Visible Pipe 1.In good condition/no external corrosion? 2.No mechanical damage or leaks? Yes J Yes 3.14o external bads? d.Visible pipe hangers/ederric bracing not loose or damaged? Yes Yes e.Sprinkler wrenches)with spare sprinklers f.Genrssl information sign attached and legible �1 Yes No I g.Has the internal inspection of pipe removing a flushing oamec k and one sprintder head h.Hydraulic ki fomation sign securely attached to rim and IWW near the end of a branch line)performed in the last 5 years?N no,conduct internal inspection N/A 5.5-Year Inspection Items(in addition to above items) a.Alarm valves and associated strainers,fitters,and restricted orifices passed internal b.t3radtvalves intsmalhr inspected,all parts operate and are in good condition inspection? N/A N/A c.Internal pipe inspection performed per KA4.g N/A - B.Testing-Report any failures in Section III 1.Quarterly Testing Items a.Mechanical water flow alarm devices actuated and flow observed? b.Main dram test for system downstream of baddlow device or pressuring reducing valve? Yes J Yes 1.System static pressure(per) 2.System residual pressure(psi) 95 15 3.Was flow observed? 4.Are results comperobleto previous tests? Ves Ves 2.Semiannual Testing Items(in addition to above items) a.Valve supervisory switches indicate movement? b.Electrical water flow alarm devices actuated and alarmed? Ces Yes - ----- - - -- 3.Annual Inspection Items(in addition to above items) a.Main drain test(for system not tested quarterly) 1.System static pressure(psi) 2.System residual pressure(psi) 95 ��I 75 3.Was flow observed? 4.Are results comparable to previous tests? Yes Yes b.Post indicating valves opened until spring or torsion felt in the rod then closed back 1/4 c A0 Sprinkles manufactured after 19207 turn? Yes N/A 2of4 d.Quick response sprinklers 20 years old or more replaced or successfully sample tested in the a.Standard response sprinklers 50 years old or more replaced or successfully sample tested in last 10 years? the last 10 years? N/A -1 N/A f.Standard response tprliddes 75 years or mac replaced or successfully sample testall In the g.Dry-type sprinklers replaced or successfully sample tasted in the lost 5 years? lost 5 years? N/A N/A h.Sprinklers subject to harsh environment replaced or successfully,sample tested in the last 5 years? N/A 1.Antifreeze solution specific gravity 1.Correct at most remote point? 2.Correct at interface with wet system? N/A I N/A 3.Correct at other test points(over 150 8aq 4.Correct type of anti6eaze? N/A N/A J.All control valves operated through full range and returned to normal position? k.Baddlow devices passed forward flow tast4 Yes N/A 1.Pressure reducing valves passed partial flow test? N/A 4.5-Year Inspection Items(in addition to above items) a.Sprinklers above high temperature tested? b.Gauges d eallad by castrated gouge or replaced? N/A J(N/A c.Pressure reducing valves passel full flow teal? N/A C.Maintenance 1.Regular maintenance items a.If any sprinkler failed the sample testing of Part It B.3 were all sprinklers represented by that b.If sprinkler has been replaced,were they proper replacements? sample replaced? N/A N,A c.Marine systems normally having fresh water were drained and refilled twice if raw water got d.Had tape inspected per manufacture's Instructions? into the system? N/A N,A e.If any of the following were discovered,was an obstruction investigation conducted7Explain reasons)and findings in Part III 1.Defective intake scream on pump supplied from sources 2.Obstructive material discharged during flow test N/A N/A 3.Foreign notarial in dry pipe valves,chair valves or pumps 4.Foreign--tested in water during drain test or plugging of inspectorle test connection N/A N/A 5.Plugging of pipe or sprirldes found during activation or work 6.Record of broken mains in vicinity N/A N/A --, 7.Abnormally frequent false-tripping of dry-pipe valves 8.Facture to flush yard piping or surrounding mains following new installation or ntpsis 9.System to returned to service after an extended period of time out of service(more then one 10.There is reason to believe the system contains sodium silicate or its derivations or highly year)? corrosive fluxes in copper pipe N/A N/A 11.Raw water was pumped Into the fire depaMuerrt conrnectlons 12.Pinhole leaks N/A N/A f.11 conditions were found that required flushing,was flushing of system conducted? g.Was a valve status teat connected after opening any dosed valves? N/A N/A h.Adjusted,repaired,reconditioned or replaced components had the associated tests and/or inspections performed N/A 2.Annual Maintenance Items(in addition to above items) a.Operating stern of all OSBY valves kibricated,completely dosed,and reopened? b.Sprinklers and spray nozzles protecting commercial cooking equipment and ventilating N/A system replaced except for bulb-type which shows no signs of grease build-up? N/A PART 3-Comments 3of4 Any'No answers,test failures or other problems found with the sprinkler system must be explained here(Asa courtesy,note on a seperate form any concerns about anything that you saw while performing your work that is not apart oft he NFPA 25 requirements including any recalled products that you happened to notice.) Conments painted pendant standard response head found in room 230 6 Tyco concealed heads painted in RIPPED gym 1 missing chrome escutcheon quick response painted in LESTERS tenant space. Pediatric office has 1)painted concealed Victauhc head on 1 st floor and 1 concealed pendant head needs to be lowered with 1/2-inch cheater. 1 FDC sign needed 1 sprinkler throughout building sign needed PART 4-inspector's Infonnation I state that the information on this is form correct at the time and place of my inspection,and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in Part III above. Company Company Address all safe fire sprinkler 375 Executive Blvd,Elmsford,NY 10523 Inspector Date Certification or License Number,N applicable [Sean Brown W106/2022 Inspector Signature r--------- ----------------------- --------------------------- Inspection performed in accordance with NFSA Standard for the Inspection,Testing,and Maintenance of Water Based Fire Protection Systems,1017 edition. 4of4 ounj Fire Alarm Inspection and Testing Report IIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIII� IZYL 1'i , 7G ��./17� 5519UE01 Date: Time: Inspection Job SERVICE ORGANIZATION PROPERTY NAME(USER) Name: AD/-T LLC dba ADT Security Services Name: LI/i (1 Dke_ Address: s�Gi 1)1 Address: Representative: /L)j ni( / 17AJ1< Owner Contact: /9 14VA )V!)I./k_-;1 License No: �c�5 / Cry� 7 / 2 ) Telephone: Telephone: / /t1` 76 i rS q 11,4 k�?�/ jr) MONITORING ENTITY APPROVING AGENCY Contact i2 0 /-�, �� Contact Telephone: / r rJ 4 e" 6 y 3 6 Telephone: Monitoring Account Ref No(CSN): TYPE TRANSMISSION SERVICE McCulloh AlarmNet RWeekly Multiplex Telular Ej Monthly Digital Cellular Radio 0 Bimonthly Reserve Priority Quarteny RF Semiannually Other (Specify): Annually Other (Specify): Cortrol Unit Manufacturer ,S J o Circuit Styles: I Model No: Number of Circuits: Software Rev.: Last Date System Had Any Service Performed: Last Date that Any Software or Configuration Was Revised: ALARM-INITIATING DEVICES AND CIRCUIT INFORMATION Quantity of Devices Circuit Style Quantity of Devices Installed Tested Manual Fire Alarm Boxes Ion Detectors -- __ Photo Detectors Duct Detectors Heat Detectors Waterflow Switches Supervisory Switches Other (Specify): Alarm verification feature is: Ej Disabled Enabled Reprinted with permission from NFPA 72®2007,National Fire Ala,m Code®,Copyright©2007,National Fire Protection Association,Quincy,MA (c.1 of a) 02169. This reprinted material is not the complete and official position of the NFPA on the referenced subject,which is represented only by the standard in its entirety. Fire Alarm Inspection and Testing Report IIIIIIIIIIIIIIIIIIIIIIIIIII�I�II IIIIIIIIIIIIIIII 5519UE01 ALARM NOTIFICATION APPLIANCES and CIRCUIT INFORMATION Quantity of Appliances Circuit Styla Quantity of Appliances Installed Tested --- -- ----- Bells --- -- Horns Chimes -- Strobes Speakers Other (Specify): No.of alarm notification appliance circuits Are circuits monitored for Integrity? C1 Yes ❑ No SUPERVISORY SIGNAL-INITIATING DEVICES and CIRCUIT INFORMATION Qty of Devices Circuit Style Qty of Devices Qty of Devices Circuit Style Qty of Devices installed Tested Installed Tested Building Temp. Fire Pump/Pump Controller Trbl Site Water Temp. Fire Pump Low Fuel Site Water Level Generator In Auto Position Fire Pump Power Generator or Controller Trouble Fire Pump Running Switch Transfer Fire Pump Auto Position Generator Engine Running _ Other (Specify): See NFPA 72 section for Protected Premises Fire Alarm Systems,Performance of SIGNALING LINE CIRCUITS Signaling Line Circuits(SLC),table for Performance of Signaling Line Circuits for Class and Style Quantity and style of signaling line circuits connected to system: Quantity Style(s): SYSTEM POWER SUPPLIES (a)Primary(Main): Nominal Voltage: �' (�' Amps: !,ig "9'% Overcurrent Protection: Type: Amps: Location(of Primary Supply Panelboard): Disconnecting Means Locations: f"t (b)Secondary(Standby): �N Storage Battery.Amp-Hr.Rating: Calculated capacity in Amp-Hrs to operate system for 1 f iy' hours Engine-driven generator dedicated to fire alarm system: Location of fuel storage: BATTERY TYPE ❑ Dry Cell ❑ Nickel-Cadmium P Sealed Lead-Acid ❑ Lead-Acid ❑ Other(Specify); (c)Emergency or standby system used as a backup to primary power supply,instead of using a secondary power supply: ❑ Emergency system described in NFPA 70,Article 700: ❑ Legally required standby described in NFPA 70,Article 701: ❑ Optional standby system described in NFPA 70,Article 702,which also meets the performance requirements of Article 700 or 701: Reprinted with permission,from NFPA 72®2007,National Fire Alarm Code®,Copyright©2007,National Fire Protection Association,Quincy,MA 02169. This reprinted material is not the complete and official position of the NFPA on the referenced subject,which is represented only by the (a 2 of C) standard In its entirety. Fire Alarm IIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIII�IIIIIIIIIIIIIII Inspection and Testing Report 5519UE01 PRIOR TO ANY TESTING NOTIFICATIONS ARE MADE Yes No Who Time Monitoring Entity m ❑ 0,V. -7/) �✓1_ Building Occupants [� ❑ L_ I� rJ (i_ Building Management 1� ❑ Other(Specify) ❑ ❑ _ AHJ Notified of Any Impairments ❑ ❑ SYSTEM TESTS and INSPECTIONS Type Visual Functional Comments Control Unit r,®yy [3 interface Equipment Ly [y] Lamps/LEDs Q Fuses ❑ ❑ Primary Power Supply Trouble Signals 0 [] Disconnect Switches Q Ground-Fault Monitoring 4 Q SECONDARY POWER Type Visual Functional PC Battery Condition 0 W Nf alb TV PC 0)�1r�/�_ (g ✓1,.ATr'.?'�2c. Lead Voltage 16 } '. :/ k" Discharge Test © _ ,� i"l Charger Test Specific Gravity ❑ TRANSIENT SUPPRESSORS ❑ REMOTE ANNUNCIATORS Q NOTIFICATION APPLIANCES l Type Visual Functional Comments Audible 0 Visible ❑ 1[ Speakers ❑ ❑ Voice Clarity ❑ INITIATING and SUPERVISORY DEVICE TESTS and INSPECTIONS Lac.&S/N Device Type Visual Functional Factory Setting Measured Setting Pass Fail ❑ ❑ -- ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ - ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Comments: Reprinted with permission from NFPA 72 ID 2007,National Fire Alarm Code®,Copyright©2007,National Fire Protection Association,Quincy,MA 02169. This reprinted material is not the complete and official position of the NFPA on the referenced subject,which is represented cnly by the (p.3 or<) standard in its entirety. ns Alarm I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII nspection and Testing Report 5519UE01 EMERGENCY COMMUNICATIONS EQUIPMENT Visual Functional Comments Phone Set ❑ ❑ Phone Jacks ❑ ❑ Off-Hook Indicator ❑ ❑ Amplifier(s) ❑ ❑ Tone Generator(s) ❑ ❑ Call-in Signal ❑ ❑ System Performance ❑ ❑ COMBINATION SYSTEMS Device Simulated Visual Operation Operation Fire Extinguisher Monitoring Device/System ❑ ❑ ❑ }}} Carbon Monoxide Detector/System ❑ ❑ ❑ w / (Specify) ❑ ❑ ❑ / INTERFACE EQUIPMENT Device Simulated SPECIAL HAZARD SYSTEMS Device Simulated Visual Operation Operation Visual Operation Operation (Specify) _ ❑ ❑ ❑ (Specify) ❑ ❑ ❑ (Specify) ❑ ❑ ❑ (Specify) ❑ ❑ ❑ (Specify) — ❑ ❑ ❑ (Specify) ❑ ❑ ❑ Special Procedure: Comments: " ' /h SUPERVISING STATION MONITORING Yes No Time Comments Alarm Signal f 0 ElJ 7 . Cy rJ Alarm Restoration Q ❑ Trouble Signal W, ❑ Supervisory Signal ❑ Supervisory Restoration [ ❑ NOTIFICATIONS THAT TESTING IS COMPLETE Yes No m Who Building Management 0 ❑ Monitoring Agency m ❑ Building Occupants ❑ ❑ Other(Specify) ❑ ❑ The following did not operate correctly(See Service Job): Service Job#: System restored to normal operation: Date: Time: On monitored alarm systems,I tested,and if necessary,connected the telephone line seizure feature to ensure it is working correctly. Y�l,7es ❑No THIS TESTING WAS"ORMED RDANCE WRH APPLICABLE NFPA STANDARDS.Name of Inspe�cter. ' Date: `�� Time: Signature: � Name of Owner or Representative: Date: Time: Signature: Reprinted with permission from NFPA 72®2007,National Fire Alarm Code®,Copyright©2007,National Fire Protection Association,Quincy,MA 02169. This reprinted material is not the complete and official position of the NFPA on the referenced subject,which is represented only by the cp,a or 4) standard in its entirety. 1/5/23 During the regular course of business, we use the times that the Fire Alarm Inspections in the building are scheduled to discuss and carry out fire drills as well as during the multiple false alarms during the course of the year. In addition, we carry at fire drills at least annually. Employees are familiar with how to evacuate patients in a safe manner. The recent dates of drills: 1/5/23 6/9/22 1/6/22 Submitted by: Wendy Tutera-Cox, Administrator i� LU IL ell • LLLL75Q • masIt • °+ • � � E E � `� r m m rn a° rn t°- rf cn in �c3 .,� r r_r nr -innn n717 T7nJ • �QyE DR 4". J O 6- V 190 40h (budvvoaW VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury «-ww.r}-ebrook.org TRUSTEES BUILDING&FIRE INSPECTOR Susan R.Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W.Morlino July 29,2022 Via Pt Class Certified Mail Rye Radiology c/o Ms.Wendy Tutera 30 Rye Ridge Plaza Rye Brook,New York 10573 Re: 30 Rye Ridge Plaza,Rye Brook,New York 10573 Dear Ms.Wendy Tutera, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection.Please note that you are required by Rye Brook Village Code§91-4.B,to undergo and successfully complete a Fire Inspection for this location at least every thirty six (36)months. In order to avoid a violation,please complete and submit the attached Fire Inspection/Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than, August 29,2022,which is thirty(30) days after the date of this notice. Please note that the property owner's notarized signature,as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three(3)years by filing a Fire Inspection/Operating Permit Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30) days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Michael J. Izzo Building&Fire Inspector mizzo(@rvebrook.org cc:Steven E. Fews,Assistant Building&Fire Inspector cc:Alena Hakanjin,Property Manager /to • �yE DR 190 40h anniovowaf VILLAGE OF RYE BROOK MAYOR 938 King Street, Rve Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J.Bradbury www.tyebrook.org TRUSTEES BUILDING&FIRE INSPECTOR Susan R.Epstein Michael J.Izzo Stephanie J. Fischer David M.Heiser Salvatore W.Morlino July 29,2022 Rye Radiology c/o Ms.Wendy Tutera 30 Rye Ridge Plaza Rye Brook,New York 10573 Re: 30 Rye Ridge Plaza,Rye Brook,New York 10573 Dear Ms.Wendy Tutera, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection.Please note that you are required by Rye Brook Village Code§91-4.13,to undergo and successfully complete a Fire Inspection for this location at least every thirty six (36)months. In order to avoid a violation,please complete and submit the attached Fire Inspection/ Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than, August 29,2022,which is thirty(30) days after the date of this notice.Please note that the property owner's notarized signature,as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three (3)years by filing a Fire Inspection/Operating Permit Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30) days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Michael J.Izzo Building&Fire Inspector mizzo&yeb�g cc:Steven E. Fews,Assistant Building&Fire Inspector cc:Alena Hakanjin,Property Manager /to C � C4Y l�, �,I.Sz- S 0'� BUILDIiN '_&"I'ARTMENT VILLA E OF RYE OK 938 KING 9 k`NY 10573 2 4 2022AUG 4) _q VILLAGE OF RYE BROOK witrtv.ry ruok:ucu , BUILDING DEPARTMENT FIRE INSPECTION / OPERATING PERMIT APPLICATION FOR OFFICE USE ONLY: x / 9 `0T—► Fee Paid: S ���U Inspection Date&Time:Awl- d/4y 41I, Sae�3 FEE SCHEDULE: Re-inspection Date& Time: Triennial & Private School Annual Inspection: =$450.00 Public Assembly Annual Inspection: <100 People=$525.00/>100 People=$775.00 Application,dated: it a•-)— is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting that a Fire Inspection be conducted at the building and premises listed below for the purpose of issuing a Permit to Operate the business, private school and/or place of public assembly in conformance with the Code of the Village of Rye Brook,the New York State Uniform Fire Prevention & BuildinQ Code, Title 19 NYCRR Part 1201, and all other applicable local, County, State & Federal laws, rules & regulations,as per detailed statement described below. /� n 1. Address: 3� �, fl.�� Q�P� SBL: /�/i 37--�� 7 Zone: C/—l" 2. Business/Occupancy Name: Qm& aA"Qs_'.. Q ALL NYS Use Class: n Q 3. Property Owner:\j,�,,j � a-\ wt• Address: „1�1 c �•��Q�4�.4 'tom t ,1��1P� CtLA- _ 1 Phone# :7N t\�5� Cell # email:'.4.r,kAt��,N 5. Business Owner:(spa-,\ C to\Any p.� ,N•� Address: t1nD A"kC.c Phone# .Iz"AS '3Xcj 817-8 Cell# email:Ac�.\� 6. Emergency Contact: w�aMjk_tr1� —( Address: .3 Ovz�s `4;� Phone# Cell# S�(sZIOZ$�\Q email: �A�c1,o 7. Inspection Escort: ,7"x Title: Phone#:Q1A lS3, gJ.x, Cell #: email:�,,�\��tra 8. Provide a brief description outlining the current and/or intended use of the property: 9. List all Hazardous Materials: 10. Occupant Load: Existing: Proposed: Other: 11. Date& Disposition of Previous Fire Inspection: 5�3��Iq Pass ❑ Fail x iz zn�i This application must include the notarized signature(s) of the legal owner(s) of the above mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK ) COUNTY OF WESTCHESTER ) as: �a►\ G[a`at.�.AA�..1-�� being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing application) and further states that he/she is the legal owner of the property to which this application pertains,or that lie/she is the lwr , for the legal owner and is duly authorized to make and file this application. That all (indicate architect,business owner,attorney,agent,etc.) 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 6-;Y� Sworn to before me this 0 day of �(�` , 20 22 day of N&.>, , 20d-� Notarry�kub�lic Notary Pu Ic Signature of Property OMAA&&WSignature of Applicant AtajA bA?pg"a� C7A�l GN\d%xkI-l1,, �' J Print Name of Property OWMr AcWr Print Name of Applicant oy TUT�R�'', T U TF STATE CO % OF NEW YORK 'f z �? STATE COS NOTARY P�Cg OF NEW YORK Qualified in ;C,c NOTARY PUBLIC ' 0' Nassau " County ( Qualified in ; Cv = ; �'. 0I TU00055M Nassau County 01 TU6005558 °'.��SS �`�EX? � �. .„„.„.o•• 812 2021