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HomeMy WebLinkAboutMP23-031 Cy Gu°ya�J V l 1�v4 Vu`�Ji .4 4 te-��V 19 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrook.org TRUSTEES ACTING BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 27,2023 The Washington&Mariaelena Caamano Family Trust Washington Caamano&Mariaelena Caamano, Co-Trustees 721 Westchester Avenue Rye Brook,New York 10573 Re: 721 Westchester Avenue, Rye Brook,New York 10573 Parcel ID#: 135.73-1-38 This document certifies that the work done under Mechanical Permit #23-031 issued on 3/17/2023 for the installation of a new gas fired boiler has been satisfactorily completed. Sincerely, Steven E. Fews Acting Building& Fire Inspector /to QyE BRC�v/f • �9�2 BUILDING DEPARTMENT ❑fUILDING 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: DATE: PERMIT# �J (� ISSUED: 1�117 SCT: !` LOCK:_ LOT:ar LOCATION: �'�V� �.X, -1A ,kj Cg J�� (-9, <3,c) )ObCCUPANCY: T �' ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION \( I 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 x s a s +•, s � O � - w � � N W •'� � as � � �,� o � `� � O x a 00 w ¢ O "' 14 cs C ,4-4 c a 3 razz � �. ' o Z ��j co 4-4 /n � � Y i.Y A.9 E" ZUZ r+hi I--I Cn G� M Z �-a tz Q 00 rj O' O � ap O �,x w 0 ] ' oo b0 W o �" tv > � uo Cn � U U O W A x z o4 .Y � a .n �I =1 Ni *l �4 a vi a n s a D LCiO� �� I BUILDING DEPARTMENT MAR 16 2023 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUT0ING DEPARTMENT www.ryebrook.org APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: �-- Approval Date: MAR 17 70) Permit Fee: $ Approval Signature: Other: Disapproved: ` (fees are non-refundable) *,t*****,t,r�,t*******,t**trtr,r*****x***,x**,t****,r,e*******,t*****,tr.********,t*,►,t******,tt*,t*,t,t,t,trr*****,r,r*,r***,r�,a,t,t REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed& Signed Application, 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (village of stye 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, 3 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or re ov 1 of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. -`- _l (� q 1. Address: .L I � I PL -7C SBL: 13S. / 3—/—,3 Ia,, -Zone; —J� 2. Property Owner: Address: -72-1 Cn -�f�-Y►(>.`ff Phone#: L I Q3 Cell#: email: 11`- 3. Contractor �n , 4 6t,JJn LU- Address: I t --�'r�s C' 5 �,Al L U tiY i h S qS Phone#:q I - �(06 n- 7 19 q Cell#: email: 4. Scope of Work:New Installation{ •Replacement(4•Removal{ )•Other( ):rI'ry l N_I M QP QC S. List Equipment: R)Ck Gu P 1 C-S C/ LZ S (V4 6. Location of Equipment: 5� Ooo,t`_ ICCy 7. Method of Installation/Removal(list all equipment needed to perform job): 1 3/3/2023 ST TE OF NEW YORK,COUNTY OF WESTCHESTER ) as: A U �I G�3I�c ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and fi�rther tales that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the On for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention& Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before the this �Aknm� Sworn to before `me this 0 to s(C4 "4 day of k ,20 day of ( �1 20 7---'—?;, Signature of Property Owner Signature of'—Applicant 'F Name of Property owner. Pr' Name of Applicant ry Public otary Public This application must be properly completed in its entirety and must include the notarized signatw;c(s)of ihd; legal owner(s)of the subject property, and the applicant of record in the spaces provided. Any appiicatiDft'rrbt properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. 2 8/112021 T.je p ul q} NIV13Wm1I3M 3 ......... ........ ....... aglow MOO""" t won q.7na puV r fYRIgesj4 jupIpeH Eiu �eaN�a �` fl paiij_pampul Siopco aldimnW �erluap�sa� :3af)13NI SNOIiV3IlddV u,flvm NIVIOW-113M HlIM 3aVW < M' 33IAH3S CINV 11V1SNI Ol ASY3 A3N3131J13 HJIH 5I?z-z5 :Haw dl A I,IVN 3jeja pnIEN 1011 s Sep Saija%,plot') . eao s ♦ MADE IM THE A Ratings , DOE two, - - — ---.._ le �- T- ------I----DOE— Ne AHt RI -� Approx Boiler i Heating Water Shipping Water Input Capacity Ratings Weight Content Chimney Notes: Model(1) MBH(2) MBH(2) MBH(3) PIDN (Lbs) (Gal.) Size (1)See Chart ---r---— -- — -T-1-- (2)Based on standard test procedures prescribed by the CGa-25 52 44 38 84.0 200 1-54'I.D.x20' United States Department of Energy. CGa-3 70 59 51 84.0 1 200 1.5 4'I.D.x 20' (3)Net AHRI ratings are based on net installed radiation CGa 4 105 88 77 84.0 240 r 2.1 5� I D.x 20'-- of sufficient quantity for the requirements of the building and nothing needs to be added for normal CGa-5 140 117 —T-102 83.5 1 280 2-7 6-I.D.x 20' piping and pick-kip.Ratings are based on a piping and CGa-6 175 1 146 127 83.2 325 3.3 6-I.D.x 20, pick-up allowance of 115.An additional allowance should T r-----T--—T-- be made for unusual piping and pick-up loads. CGa-7 210 175 152 83.0 370 3.8 7-I.D.x 20' CGa boilers are C.S.A design certified for installation on CGa--- 8 1 245--'�4 1 7 82.7 425 4.4 7'I.D.x 20' combustible flooring.Tested for 50 psi working pressure. Dimensions i- Dimensions FSupply Return Neat rp LP GasCrate Dimensions Inches Piping Piping Connection (Outside Measurements-In,) Model A D W H In.(1) In.(1) Size Inches Length Width Height CGa-25 5 4 10 45 3/8 3/4 —3/4 --1/2 1 277 1 271/2 1 31 1/2 Torn New - CGa-3 1 5 1 4 1 10 1 52 3/8 1 1 1 1 1 1/2 1 27 1 271/2 1 31 1/2 e -- CG21-4 1 61/21 5 1 13 1 54 3/8 1 1 1 1 1 1/2 1 27 1 271/2 1 31 1/2 CGa-5 1 81 6 1 16 57 7/8 T 1 1 1— - 30 271/2 31 1/2 led V01M t�no sopW ed w to smne CGa-6 91/2 6 19 60 7/8 1 1/4 1 1/4 1/2 33 271/2 31 1/2 °a°`mco„n ded i Me size.For supper CGa-7-1 11- 1 7 1 22 1 621/8 1 1 1/4 1 1 1/4 1 3/4— 1 36 27� 1/2 1 1/2 GGa 8 12- 1�/2�-25 64 7/8 1 1/2 1 1/2 3/4 42 271/2 31 1/2 „ , FrA D 6 . t ►s K f indl GPM" GPM" � 7Ir 101 l — 12-- 1 -- ----- 9 r.- -W b, TW vfew SIDE ELEVATION .-- — — M9hebWdmMrt I�o igdOoNbwChmawirmbe WonMM►WW tsr nen iballr is Flowwp*or wprn win be dilwto dwtbr*s Ma of cb=Ww fto pl AN& Standard and Additional Equipmient Standard Equipment: Rollout Thermal Fuse Element Additional Equipment: Factory Tested High-Limit Temperature Control Taco 007 Circulator Two-Piece Top Jacket Panel Circulator(when ordered) Expansion Tank Package(expansion tank,fill Insulated Extended Steel Jacket Spill Switch &check valve,auto air vent and fittings): *� Cast Iron Sections with Buitt-in Air Separator 30 PSI ASME Relief Valve(boiler sections #109-sizes 25 thru 5:#110-sizes 6 thru 8. Radiation Plates tested for 50 PSI working pressure) Shipped in separate carton. Vertical Draft Hood Combination Pressure-Temperature Gauge W-M 5&10 Year Homeowner Protection Plan Automatic Vent Damper Drain Valve W-M Indirect-fired Water Heaters Combination Gas Valve for 24 Volt Integrated Boiler Control Module with W-M Pool Heaters Wiring Harness Intermittent Electronic Ignition System W-M Baseboard Units Non-Linting Pilot Burner &Indicator/Diagnostic Lights M Stainless Steel Burners 40 VA Transformer Electrical Junction Box Plug-in Connector and Wiring I FM11 UlEIL-n1clAIN I' - own In the interest of continual improvements in product and performance,Wed-McLain reserves the right to change specifications without notice. H C-848(0812) OFERGUSON Home Heating&Cooling Hydronics Boilers UIEIL-McLA1N This product has been replaced by View Product Weil Mclain Residential Boiler 166 MBH Natural Gas Partt..W381359078 Weil Mclain CGa"-6 CG Series 4 Residential Gas Boiler 175 MBH Propane and Natural Gas Part.aW3813 5 7 8 08 Item#4424175 Manufacturer Part 9381357808 Discontinued INPUT MBH : 245 MBH C _J Packaging Info: Quantity Per Each:1,Inner pack:l How to get it: © Pick Up Not Available ® Shipping 0 in Nurv,uucl,NJ Call for Availabillty:(201)76"080 Product Details Natural draft venting through a vertical vent or chimney Documents Stainless steel burners for quieter ignition,longer life,and improved combustion Specification Installation Gas fired water boiler with cast iron sections Warranty Pilotless ignition Energy Guide AGA input:175 mbh Use And Care DOE heating capacity:146 mbh Net rating:127 mbh AHRI Reference Number:2101648 Specifications AFUE:83.20 ASME Specifications:Yes Application:Residential BTU:245000 BTU Heat Rating:146000 Btu/h CEC Compliant:For Sale in CA Privacy Information X We use cookies to ensure fast,reliable,and secure operations,and to give you the best possible experience when using our website.We use both sesslon-based cookies and persistent cookies.We also allow the use of third-party cookies by certain authorized third parties with whom we execute marketing campaigns.For more information, please refer to our Privacy Poficv and Cookie Policy. • Installation Type:Floor Mount Length:42 in MBH:245 Material:Cast Iron Origin:Domestic Phase:Single Phase Power Source:Gas Return Pipe Connection:1-1/4 in Stages:Single Supply Pipe Connection:1-1/4 in UL Listed:Yes Vent Type:B-Vent/L-Vent Volts:120V Width:19 in Popular Products 1/2 In.Copper 90 Degree Elbow ,Y4 i 50 gal.Tall 40 MBH Potable Water and Residential Natural Gas Water Heater �1. r f- 9 k 50 gal.Tall 4.5kW 2-Element Residential Electric Water Heater Privacy Information X We use cookies to ensure fast,reliable,and secure operations,and to give you the best possible eyperience when using our website.We use both session-based cookies and persistent cookies.We also allow the use of third-party cookies by certain authorized third parties with whom we execute marketing campaigns.For more information, please refer to our Privacy Policy and Cookie Policy. 50 gal.Tall 40 MBH Potable Water and Residential Natural Gas Water Heater trl 50 gal.Tall 40 MBH Residential Natural Gas Water Heater na. s �i> N f 40 gal.Short 4500W 2-Element Residential Electric Water Heater ------------ www.ferguson.COM LEAD LAW WARNING:In accordance with the US Federal or other States laws It Is Illegal to Install products that are not"lead free" certified in potable water systems anticipated for human consumption.Refer to your local plumbing inspector or manufacturer for more details. Privacy Information X We use cookies to ensure fast,reliable,and secure operations,and to give you the best possible experience when using our website.We use both session-based cookies and persistent cookies.We also allow the use of third-party cookies by certain authorized third parties with whom we execute marketing campaigns.For more information, please refer to our PrivacyBolicy,and Cookie Policy,. r� ACORO CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DD(IYYYI �/ 2i 2712023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER-FIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Certificate Unit Edgewood Partners Insurance Center PHONE 404 7811700 ,A FAX No): 1 California Street, Suite 400 - -- - San Francisco CA 94105 ADDRESS: Apexcerts@epicbrokers.com ----- -. INSUR�BI AFFORDING COVERAGE NAIC M___ it nsss#=Q822 7 INSURER A:Liberty Mutual Fire Ins Co _- 23035 _ INSURED APEXSVCP-INSURE R S:LM Insurance Corporation 33600 Aqueduct Plumbing,Heating&Cooling, LLC. ------ _—- __-- ----- 115 Wall Street INtwRERc:Liberty Insurance Corporation 42404 Valhalla. NY 10595 INSURERD:See Attached plSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1221623756 REVISION NUMBER: -HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUa POLICY EFF POLICY F,tP - - LTR TYPE OF INSURANCE INSD POLICY NUMBER LIMITS A X COMYERCIAL GENERAL LIABILITY EB2-051-292549-062 4/1/2022 4/1/2023 EACH OCCURRENCE $2,000.000 �SAMMAG'E S(Ea TE l CLAIMS-MADE L�OCCUR I � i PREMISES(Ea occurren_ $300,000____ _ j MED EXP(Any one ) $10.000 X SIR 9250,000 j PERSONAL&ADV INJURY $2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4.000,000 X POLICY C JES I T i"LOC PRODUCTS-COMPIOP AGG s 4,000,000 R:OTH S A AUTOMOBILELIABRJTY AS2.651.292549.022 4/1/2022 4/1/2023 CO BIN OSINGLELIMIT $2000.000 Ea accident) _ X ANY AUTO % BODILY INJURY(Per person) S OWNED :SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per ecGeent) S HIRED NON-OWNED PROPERTY DAMAG $ AUTOS ONLY AUTOS ONLY Per eccidMt�_ $ D UMBRELLA LIAR X ;OCCUR See Attached 4/1/2022 4/1/2023 EACH OCCURRENCE $See Attached X ''EXCESS L1A8 �-- --- - - -- '- CLAIMS44ADEi AGGREGATE S See Attached DED RETENTION S g WORKERS COMPENSATION WA5-651)-292549.012 41/2022 4/1/2023 IX P R OTH- C AND EMPLOYERS'LIABILITY Y/N WA7-65D-292549.092 516/2022 4/1/2023 i----- STAT"TE _ . ER ANYPROPRIETOR/PARTNERIEXECUTIVE [I N/A E.L.EACH ACCIDENT S 1,000 000 OFFICER/MEMBEREXCLUDED7 --- --- - -- - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1.000.000 It yes,tlescnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB S 1,000,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Village of Rye Brook,to the extent required by written contract,is an additional insured with respect to general liability and auto liability.Umbrella is follow form over the General Liability,Auto Liability and Employers Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook 938 King St. AUTHORIZED RE?PRESEN rATIVE Rye Brook NY 10573 r, 6(6UA0.A . � (d)1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NEW i Workers' YORK CERTIFICATE OF POR ----- STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name&Address of Insured(use street address only) 1b. Business Telephone Number of Insured Aqueduct Plumbing, Heating & Cooling. LLC 914-666-9199 115 Wail Street Valhalla NY 10595 1c. NYS Unemployment Insurance Employer Registration Number of Insured 5538703 Work Location of Insured (Only required if coverage is specifically itmited to Federal Ernpbyer Identification Number of Insured or Social Security certain locations in New York State �e. a Wrap-Up Policy) 10 Number 88-3136026 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) LM Insurance Corporation Village of Rye Brook 3b.Policy Number of Entity Listed in Box'Ia" 938 King St Rye Brook NY 10573 WA5-65D-292549-012 3c. Policy effective period 9/12/2022 to 4/1/2023 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all palreVofficers induoedi all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box 1 a'for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certfrcate of Insurance to the entity listed above as the certificate holder m box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage;rdi:ated on this Certficate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or Its licensed agent,or until the policy expiration date listed in box "3c", whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'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, 1 certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Talor Powers "'atNe o•bcenseo agent of insurance cemer; Approved by: 10/7/2022 (Signature) (pate Title: Sr. Client Service Coordinator Telephone Number of authorized representative or licensed agent of insurance carrier 470-539-5761 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov 70712313 1 5-292549 I C105.2 9/22-4/23 Aqueduct 3lumbing, Heating 4 C001 . :Annie Hyazka 1 13/7/232. 1:36:51 PH (CDT) I Page i of