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MP23-047
�QyE QR tc 4 .t V L' IL G O . 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.ryebrookny.gov_ TRUSTEES BUILDING& FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE July 31,2024 Patricia Walker Trustee of the John Henry Herkert Living Trust 454 North Ridge Street Rye Brook,New York 10573 Re: 454 North Ridge Street,Rye Brook,New York 10573 Parcel ID#: 129.60-1-33 This document certifies that the work done under Mechanical Permit #23-047 issued on 4/12/2023 for the installation of two new condensers and two new air handlers have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �E QRnv/s o`` tim 1982 BUILDING DEPARTMENT ❑13UILDING INSPECTOR mf 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 : N l7 r 1` 1C Q - 1"l G DATE: 2 PERMIT# M` 2 3 J `! ISSUED:Y-iz" t.3 SECT: BLOCK: LOT: LOCATION: I OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... D ' ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION 7 ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER w M N N 00 tp N e Ong' o a R bA ■ a � L N CS 0 F � o LZ W o MCI -�"-t p � C7 E•+ i � ° g 8 °"� Z b : W W � �" O ►� � a " y a v � � A w � � co 0 w4 - M� W w v�i In A o _ a op A � u � M H W v v cy -cd o F W N ' V Zoe a-R u O w a! v ~ 3 w rn a " LO z W w o :y s o .. a z a u - O a w o � � . a P-41 0.41 Volx � � - BUILDN .DEPARTMENT D Q VIL E OF RYV,° OOK 938 KING ET RYE BROA,NY 10573 APR 1 2 2Q23 14)939-0668 yebrook.or� VILLAGE OF RYE BROOK �7; a BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING,VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: APR 1 2 1023 PERMIT#: 1-- 1DQ3 / 7 Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) 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 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, q is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as 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: L{15,A n�J.'� c�ye �t', SBL: i Z l.la(1- i 55 Zone:/ l 2. Property Owner: Address:' " N. ►R a t S+ Phone#: cl l�{ 9 $O-�l �4 Cell M email:_P W S ce n i. (� l ahaa.c.rr, 3. Contractor: m qc i o'6c-u n k Address: (o Q C�re�S a�►d S 'Ri Z Phone#: I`i-5$U-'7o`i3 Cell#: email: Pecr +t ® �c ucgrn�nc.co�+-• 4. Scope of Work:New Installation( }•Replacement(0 Removal( )•Other( ): 5. List Equipment: o C-z) C o c e cry -T o 2, i n 6. Location of Equipment: Con�e ct.Se UC'cx-%C- C%)�CIQ a r-Z jr� erY+cr►i c�n� ��� 4ir hQndl�r ucg�eL r, �coar-. o qca(Sy , 7. Method of Installation/Removal(list all equipment needed to perform job): t 3/3/2023 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: (n o'C-%C. n% ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this II ` Sworn to before me this y day of AQr i ,20 'Z'3 day of 20 23 Signature of Property Owner igna f Applicant OaA6 4:�%Q \r)(;AVeC- (N-)rac-id '�:C u n, Print Name of Property Owner Print Name of Applicant '-�- Qh�rt= Notary Pub is Notary Public DiANE M HOWIE DIANE M HOWI€ Notary Public-State of New York Notary Public-State of New York NO.01 H06391666 NO.01 H06391666 Qualified in Westchester County Qualified in Westchester County My Commission Expires May 13,2027 My Commission Expires May 13,2027 This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(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 3/3/2023 FIRST CO. P.O. BOX 270969- DALLAS,TEXAS 75227 PH. (214) 388-5751 1 FAX(214) 388-2255 WWW.FIRSTCO.COM HBXB- HW Series AquaThwal) by First Co. Hydronic Air Handler Without Pump Cooling or Heat Pump / HW Heat 1 .5 - 5Tons Up to 131,700 BTUH Heating H BXB-HW Series The HBXB-HW air handler is designed for use with today's high efficiency split-system condensing units, heat pumps, hot water boilers, and Tankless Water Heaters. Boiler applications: The HBXB-HW can be directly wired to a boiler without adding additional relays -� or related controls. Multiple air handlers can be connected to a single boiler to provide comfortable, efficient, whole house hydronic space heating. Tankless Water Heater applications: For Tankless Water Heater applications, install the appropriate pump for the pressure drop. Cooling efficiencies are up to 15 SEER, depending on the outdoor condensing unit or heat pump model. • c • These fan coils are compatible with any source of C hot water that doesn't exceed 1800 and is NSF/ANSI certified for use with domestic water. First Co's customer is ultimately responsible for confirming which fan coil models are compatible with selected outdoor unit(s) and which expansion valves (if any) are required. To determine certified indoor/ outdoor combinations,go to www.firstco.com or contact the factory. t 1 HBXB-HW SERIES SPEC STANDARD FEATURES: • Multi-function micro-processor circuit board with these standard features: • Blower start relay - Eliminates field installed boiler relay, allowing direct wiring from the boiler to the air handler • Blower-on fan delay - (heating mode) - preheats the HW coil for 45 seconds. • Blower-off fan delay - (heating and cooling models) - blower continues to operate for 45 seconds after thermostat is satisfied, for increased efficiency. • 120V or 24V zone valve control - The micro-pro-cessor powers either 120V or 24V field supplied motorized zone valves. • Factory or field installed R-410A TXV (cooling or heat pump operation) (non-bleed type) • Manual Air Vent on hot water coil • Blower door shut-off switch (except 60HBXB-HW) • Slide out hot water coil for easier service • Copper tube heating and cooling coils • Compatible with all major brands of split condensing units and heat pumps • Attractive baked-on powder coated cabinet • Primary and secondary condensate drain connections • Easily accessible 1" filter • Cabinet air leakage is no more the 2% when tested in accordance with ASHRAE 193 OPTIONAL ACCESSORIES: (see p.2) • Freeze Protector - Reduces the possibility of the water coil freezing by switching the unit to the heating mode if the water temperature is nearing freezing conditions. • High capacity Flow Control Module for Tankless Water Heater applications (#940-2CV) FIP. T Cr?. 2 HBXB-HW SERIES SPEC H BXB HW Series HOT WATER XBH 7/8"O.D.CONNECTION - it 1/8 O.D.on 6UHHX&HWI g C ----11111. 44 B ----al. DX COOLING 3 � I*-H WATER_� OPENING �_ WATER _ OUT �-------------7_7�' IN --------------1 HW HEATING -------------- ------ HOT WATER COIL ---r------ --- 0o�24V WIRING 1 1 0 ELECTRICAL 1*1 COMPARTMENT POWER SUPPLY HORIZONTAL I i (K.O.(both sides) A•• CONVERTIBLE ' DRAIN PAN _AIRFLOW V,L7ER TfA- COOLING COIL DIRECT �- r EXPANSION a tt oio C CI87e0 U.S COIL CONNECTIONS I E—1I I�FFTER I D—�I (ALL'SWEATJ DRAIN (See PA for Model Numbers) CONNECTINS 3/4 MPT BLOWER DATA UPFLOW/HORIZONTAL ONLY ACCESSORIES UNIT MOTOR MIN. MAX. MOTOR CFM—EXTERNALSTATICPRESSURE (field installed) MODEL HP-AMPS CKT. CKT. SPEED (120V) AMPACITY PROTECTION CONN. 0.05 0.10 0.20 0.30 0.40 0.50 HIGH 810 780 715 650 580 500 FLOW CONTROL MODULE 18H BXB-HW - MED. 680 655 600 545 490 420 MED.LOW S30 SOS 460 415 360 295 LOW 350 325 270 220 160 --- PART NUMBER FOR HIGH 950 920 855 790 720 645 940-2CV 18-60HBXB-HW 24HBXB-HW 1/5-5., 6.38 MED. 860 835 785 720 650 580 LOW 780 755 705 650 590 510 NOTE: HIGH 1120 1095 1041 995 9411 1180 Flow Control Module is required when 30HBXB-HW 1/5-5.1 6.38 = MED. 850 840 810 780 740 690 LOW 680 670 655 625 S85 510 connecting to individual Tankless Water HIGH 1340 1310 1250 1190 1120 1050 Heaters.Contact factory for assistance. 36HBXB-HW 1/2-8.5 10.63 _ MED. 1290 1260 1200 1140 1080 1000 LOW 1200 1170 1120 1070 1010 940 HIGH 1810 1780 1720 1660 1590 1530 EXPANSION VALVE KITS 48HBXB-HW 3/4-10.7 13,38 5 MED. 1570 1550 1510 1460 1400 1340 (Field installed)(cooling only or heat LOW 1280 1260 1220 1180 1130 1050 pump) HIGH 2160 2125 2055 1980 1895 1810 60HBX8-HW 1 11.5 14,38 15 MED. 1865 1840 1785 1710 1620 1525 PART NUMBER LOW 1560 1540 1490 1 1435 1365 1260 R22 FITS NOTES: 9EVR22-4 18/24H BXB-H W 1. All models are approved for installation with 0"clearance to combustible materials. 2. Use 48HBXB-HW for 3.5 ton applications and field-convert fan motor to medium speed. 9EVR22-5 30/36HBXB-HW 9EVR22-6 48/60HBXB-HW PHYSICAL DIMENSIONS R-410A UNIT FILTER 9 EVR410-3 18/24HBXB-H W MODEL A B C D E F G H SIZE 9EVR410-4 30/36HBXB-HW 18HBXB-HW 40 20 20 18-1/2 16 2 18 16 18 X 20 X 1 9EVR410-5 48/60HBXB-HW 24 H B X B-H W NOTES: 30HBXB-HW 42 23 20 21-112 16 2 18 19 20 X 22 X 1 1. Above expansion valve kits are approved 36HBXB-HW for both cooling only(non heat pump)and heat pump applications. 48HBXB-HW 48 28 21-1/4 26-1/4 17-1/4 2 18 24 20X25X1 2. Valves are non-bleed type. Field added. Hard start kit may be required. (2 required) w 60HBXB-HW 52 28 25-1/4 26-1/2 21-1/4 2 22 24 14 X u X 1 3. Valves have scre on connections. RECOGNIZED FREEZE PROTECTOR COIL CONNECTIONS COMPONENT NSFIANS KIT NUMBER FOR UNIT LIQUID SUCTION 941-1 18-60HBXB-HW SIZE 18/24 3/8 S/H ;n o L�WARNING AVERTISsEMENT ADVERTENCIA 30/36 3/8 3/4 ono 0' 169,2016 c,�.ro aRePoen+ oN,r 1 Ginter et TrouDHs M t'apparcil rcOro4utteur Cancer Y Dano RaProart 48/60 1/2 7/8 Intertek arw.P65W�rni�a ca.ao »rxa. 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TYPICAL WIRING SCHEMATIC FOR MULTIPLE ZONE CONNECTIONS WITH ZONE VALVES 24 VOLT 4 CONDUCTOR 24 VOLT CLASS 2 WIRING CLASS 2 WIRING CLASS 2 WIRING -T -4. ------------- ---------------0-T - ..... ......... G -------------0-- G G ------------ G HBXB-HW —T -0-------- ........ ......... ..........0-T - HBXB-HW W ------------- W FAN COIL FAN COIL W - -------- w R R -24VA10-- -a-24V- R R #-24V- y C C y 24V REMOTE : BRN 4N : 24V REMOTE THERMOSTAT • PIGTAIL LEADS FOR T T PIGTAIL LEADS FOR THERMOSTAT MOTORIZED VALVE MOTORIZED VALVE -0- CAP OFF NOTE: CAP OFF CONDENSER BROWN IF NO 1 BROWN 11 NO CONDENSER CONTACTOR CONDENSING UNIT CONDENSING UNIT CONTACTOR IS USED 24V MOTORIZED 24V MOTORIZED 15 USED ZONE VALVE ZONE VALVE TYPICAL WIRING SCHEMATIC FOR MULTIPLE ZONE CONNECTIONS TO TACO SR-5041506 SWITCHING RELAY 24 VOLT 24 VOLT CLASS 2 WIRING CLASS 2 WIRING CLASS 2 WIRING T -41,------------ ----------- -------------4P--T G ------------- G T -*-------- ---------- ...........*--T G G HBXB-HW HBXB-HW W ------------- W FAN COIL FAN COIL W ..............W RR -24V-1110- .4-24V R ..............R -24V-10. -4-24V C y -7C BRN 24V REMOTE 24V REMOTE TACO G THERMOSTAT THERMOSTAT SR 5 ZONE 1 ZONE 2 04 SWITCHING ...... RELAY x x 0 NOTE: CAP OFF NOTE: CAP OFF CONDENSER BROWN IF NO -------------------- I BROWN IF NO CONDENSER CONTACTOR CONDENSING UNIT 120V CIRCULATOR CONDENSING UNIT J IS USED IS IS USED CONTACTOR T ........BOILER T Catalog No.HBXB-HW321(Replaces HBXB-HW420) FIRST CO. 5 HBXB-HW SERIES SPEC Heating 4-Air Conditioning Jr M ana ASXH3 AMERICA'S BRAND FOR COMFORT` ENERGY-EFFICIENT SPLIT SYSTEM AIR CONDITIONER UP To 13.4 SEER2 1'z TO 5 ToNs Contents Nomenclature.......................................2 Product Specifications ..........................3 Expanded Cooling Data ........................4 Performance Data...............................18 Wiring Diagram ...................................20 Dimensions .........................................21 Accessories .........................................21 Standard Features Cabinet Features • Energy-efficient scroll compressor • Removable grille-style top design • High-density foam compressor compliant with UL 60335-2-40 sound blanket • Venturi for increased velocity of airflow • Advanced Copeland®CoreSenseTM • Attractive Architectural Gray powder-paint Technology finish with 500-hour salt-spray approval • Copper tube/enhanced aluminum • Wire fan discharge grille fin coil-5mm diameter • Steel louver coil guard • Single-speed PSC condenser fan motor . Top and side maintenance access • Factory-installed filter drier . Single-panel access to controls with space • Sweat connection service valves provided for field-installed accessories with easy access to gauge ports • Contactor with lug connection • Ground lug connection • AHRI Certified;ETL Listed ON Inartek Iso Complete warranty deta,ls available dealer or at www.amana-hac.corn.To receive the 10-Year Parts Limited Warranty,online registration must be cnmpkted within 60 days of Installation.online registration Is not required In Callfornla or Quebec.The duration of warranty coverages In Tms differs in some rases. SS-ASXH3 www.amana-hac.com 11/22 Amana•is a registered trademark of Maytag Corporation or Its related companies and Is used under license.All rights reserved. NOMENCLATURE A S X H 3 0 36 1 0 A A 1 2 3 4 5 6 7,8 9 11 12 Brand Minor Rev A-Amanao Brand A Major Rev Product Category A S Split System R-410A Variation Unit Type Electrical X Condenser 1 208/230 V,1 Phase,60 Hz Z Heat Pump Nominal Tonnage Feature 18-1Y.tons 36-3.0 Tons N Value C Premium 24-2 tons 42-3.5 Tons H Enhanced V Ultimate 30-2Yi tons 48-4.0 Tons 60-5.0Tons SEER2 Sales Region 13.4 -13.7=3 16.6-17.5=7 N -North 13.8-14.5=4 17.6-18.5=8 S -Southeast&North 14.6-15.5=5 18.6-19.5=9 0-Ali Region 15.6-16.5=6 19.6+ =0 2 www.amana-hac.com SS-ASXH3 PRODUCT SPECIFICATIONS N1810A' N3010A IA' N42 N4810A* EMKkall.111 I COOLING CAPACITY Nominal Cooling(BTU/h) 18,000 24,000 30,000 36,000 42,000 48,000 60,D00 Decibels(dBA) 68.0 68.0 72.0 70.0 69.0 73.0 73.0 COMPRESSOR RLA 9.0 11.5 12.8 14.1 17.7 18.5 2S.6 LRA 47.5 59.5 67.8 87.4 110.2 124 150 Stage Single Single Single Single Single Single Single Type Scroll Scroll Scroll Scroll Scroll Scroll Scroll CONDENSER FAN MOTOR Motor Type PSC PSC PSC PSC PSC PSC PSC Horsepower(RPM) 1/8 1/8 1/6 1/6 1/6 1/4 1/4 FLA 0.70 0.70 0.9S 0.95 0.95 1.30 1.30 REFRIGERATION SYSTEM Refrigerant Line Size' Liquid Line Size("O.D.) %11 W. W. W. W. W. W, Suction Line Size("O.D.) �" W. lya" 1'/a" 1X" Refrigerant Connection Size Liquid Valve Size("O.D.) W. W. W. W. W. W. W. Suction Valve Size("O.D.)=,a W. Y., '/." W. '/." Valve Connection Type Sweat Sweat Sweat Sweat Sweat Sweat Sweat Refrigerant Charge4 62 75 78 71 115 120 130 ELECTRICAL DATA Voltage-Phase 208/230-1 208/230-1 208/230-1 208/230-1 208/230-1 208/230-1 208/230-1 Minimum Circuit Ampacity S 12.0 15.1 17.0 18.6 23.1 24.4 33.3 Max.Overcurrent Protection" 20 25 25 30 40 40 50 Min/Max Volts 197/253 197/253 197/2S3 197/253 197/2S3 197/253 197/253 Electrical Conduit Size X"or W y"or W X"or 3:" Y"I or W" Y"or yVIor�" Y"or Equipment Weight(Ibs) 122 136 151 1S3 188 215 227 Ship Weight(Ibs) 135 149 166 168 203 235 1 247 ' Line sizes denoted for 25'line sets,tested and rated in accordance with AHRI Standard 210/240.For other line-set lengths or sizes, refer to the installation&Operating instructions and/or the long line-set guidelines. ' Wire size should be determined in accordance with National Electrical Codes;extensive wire runs will require larger wire sizes ' Must use time-delay fuses or HACR-type circuit breakers of the same size as noted. ' Installer will need to supply%"to K"adapters for suction line connections. s Installer will need to supply%"to 1Y."adapters for suction line connections. Must use time-delay fuses or HACR-type circuit breakers of the same size as noted. NoTEs • Always check the S&R plate for electrical data on the unit being installed. SS-ASXH3 www.amana-hac.com 3 ExPANDED COOLING DATA -ASXH3N181DA*/CA*FA1818*6A*+EEP W C W o m d b N ID, 1f1 cn cn d m 'O d Ol to V ti 'O" o c-i n V ti o `ti ti n y rl a E E ui Lq Ln mvm now-� mv v6 tiwtim ? n m - oO10 m °�° m `? mm m my wn N u •� O .--i d .--� ti o O ti O m d ti ti ^ ti Ln ti n ID d - ti R to 3 J pp Y O O o0 ^ �O t0 ti d ti O n lD ti N ^ d ^� n V O ry O1 ^ w O n �° O •-� .--� O ti t0 O o 0 ID t0 ry w N O `� �O N t0 d d O^ .,� 0 ~ Vl m n w i0 d m N ^ tD w m m w O •n O � ^ ^ Ln w d O w ^ O w l • .�-� O .-i d ti o '-� ti d ti ti o '~ .--i t0 d .-� d o '"� r-i tU d tO.y o ti ti t0 d ti ti o '� ti O d ti O e10 pp pO tD n ti O O tD ^ ti n A �O � O � � L ti ID � O O r Ln ,dy � � O °t 1� � � tD O .ti 1° d .-i ti O `~ ,y t0 d ti .�-� O '� ti t0 d .-� ti .-1 N ,y t0 d .ti ti .--' N ti d .ti ti tit° d ti Ln Oo O w C f�-1 N O rj wV f�-1 ' N N O N O 1p O ti .�-� O N ^ l0 O ti d Ln In o ti n d to W M w Ln m m to m m .-+ m - m .-. Ln a w v udi oo vi ^ Ln m `l m m ^ Ln `^n ui ^ m w m °�° Ln ao w Ln ^ m o ro m m d m w, 'n. m n m � � m .-• ,-, o .-� � to � m .-, ,-, o ,-, � c 'n m u°i w udi °o m v� `° n v^i a0 rvn vrvi to n o� m m N do �D U~1 e n ,+ v'^i °o uNi ° w p M ao o vm o a� f p p r' � vi m - ti o '� 'n m .-- .1D-i o "� ,� �n m m- N O ^� ,y vi rn .� p ^� .� m .-i c W C 6 ~ .� O d a m to o m t0 o Ln .� o d a m o Ln H m .-� C� Lq N m ti ti°y O Ul ri Ln m M to O N Ui T LA O N m V lD N Ln m ti `w. O ^' N Vf T m--i F W Q m 3 N lfl an d M In u d Ln v .� oo m 'n d v '� o m o m m v ry „� r u a o C w 0 Z � mmo ,...idoo mmmo ,..� too Nm w Lqm � rvaory � r� mo .tidoo °+ m ^ or, too N . �or' rvooN d f U' ti O .--i m ti ti p `� ,dy vi m .�-� o "-� N V1 m .�-i .^-� O .-t r-i ul m .d-' ti o ti '-i m ti p "-� mn-� d Ln _2 O a Z ri 'n W ~ N O I� w .^-I d N V r,, w O N N O ri O^ N d `ti N ri ry Ln V ~ N a V N ry V a o '-i vi m - - o .--� 'n m .-, .� o .-i 'n m .� ,� o .� m m .ti .. o ,� '^ m t w � � � vim d, ^� � � '4 vi � d � � � � m m d ° � N a n m q � ^� � vi m .d-t ^� oq N � � m � .y r, N lO N f� d 1n m 00 w* N L d w 0 W d vl M m l0 N O ono 00 ed-1 N d N .d-1 ~ N d N --I w Lq `� N � ONO 'r w � N d N .di oo '~ N d N .-I oo N oo ct .ti O .--i w- O .-i ti o .-� .--i O .-� .ti ci O n I� Lq ! w m wNV. N N N d N ry W r�/1 n ry N a N � W ^ pry Q N ti j m N ti wI� m W N o0 " 4 00 m 1� cj W N DD M n ^ .^-1 N a0 d f� O N N V ry .m-I p N a N M O N C N W Ln o d O c-1 d C d Ln ry o Ol 00 m d d r0-I O '-1 p 0 VI ^'� O m rV E a�i o •-� .-. v d m a` o '+ ri c Ln d °,.�' o v in d oo .d, '-+. o v m m a ^� m-� v m w 'n `� - o a m w m ao °' v rm+ m m n 11 tn Q V m oo tp `o ,� o m m �-1 O rl d N r-I r1 O '~ rl d N .--1 N o ~ r1 d N e-i N o N r-1 m N e-1 o ti �.y d N e-I `-1 O ~ •--1 d N ~ G lD 1� d to O d o 0 $ n to o w N m V w O w d cq r N d o d O O m ti Lnp 10 N m 1� tD O o0 d •L• Lq r-I d N ti 00 lD ,y '."! d N .M-i i0 ''"! d N .m-1 ^ % N ~ d N .m-1 w N N ~ d N .my ^ O ~ n d Ln ry N o m m I� W m o In o O .--� w o n N o In m m p m m N '� N to o N O p d ,y O O n m E m H p pN .--' d ry .Ni ,^-1 o .--' d N N W O .--I .y d N .m-� N o ^� ,..j d N .Ni .^-i O N .-� d f�V .m-� o N .ti d N .m-� 2 E a!I m � l- as a mC � as a m � F. as a m � H 3 as a m � F- ?� as a mCH �? a a Z m a Y Q 2 d Y Q 2 a Y Q 2 2 - a - E 2 JO N d E 2 JO - a - Q JO O J O o Ln pO LnLf pOo Ln n Lm O w N t0 b m o w � n O 4 www.amana-hac.com SS-ASXH3 EXPANDED COOLING DATA -ASXH3N3010A*/C4*FA3626*6A*+EEP (CONT.) m In ° o ry o o n. o n D ^? o d n ao m n o ID ° ^ o w In m `v c ci Ory N nj n n N N m 00 tO n ry N N O n M N N w N N d O .-1 N w .-1 3 T ry O m 4 I-I N O m rl d N 0 '-I m •i n N O ry M .--I d 'D N O ry M �--1 V 'n-I N O ry m - D .n� n Cl E E ID N n N n N m 0 w m m m N d m m r-I m '-I O w In w dd d 0 m m - m n o d n N ~ N n w N N M .N-1 d tHO Ul tD ry '-I ry W lD uj O N '-1 ry n lD m O N .-I ry w lD m o m O m N ry W ID vTi u N N '-1 d N O N O m r-I d .-1 N .-V M .--I d '-I N e-1 m rl d N N N M '-1 � O E o ao Q O pD H r m � ry � Lq �N Ill do ry � N � d � Nd � N m N tD d O N ON N 00 tMD > � N M e1 d �"I N •-1 m rl d '-I N N r1 M .--I d r-1 N .-1 m rl d � > Y O O d o IO o m 0 ID M m O O tD pp p W O w In w m rl O m m w o d O N O tD m N ry O m rry-I d rm-I O ry M .N-I d .11l-1 M o N r`! N n l0 M m N n od Q N n tD d O N nj n tD O d a m O `^ o ID n rl d ^ m '-I o 'ti W o In m ti n '. ID I^ N m E In m �._j O O ^ 00 N m d m lD N m rl rl n .-I IXl m m n 0 tll d Q ry o .-i N �y om ri N O ~ d N 0 ti ry LmD N O N ry to N O N N .y M ID ry O ry ry '-I m IUD O O ry w O d ,In-I ID n ry w O tl0 o wm ory O mm m 'D O N Iq N O d .IJI-I tD w ry � O N to n 9 N .-i m o No f V O.-1 d '-I N N '-I d '-I N O ry .-1 d r-1 N - N .--I d '-I O N Oo Ln O N Iry Il? Oui o d .DR 0 ID m a0 O m n O m In O In m o o tD O n In m o n .-I m ID N ri N N r-I d .--1 N rl N N .--I d ."I N O N ry r~-I d r-1 N O ry .--I d '-1 o � r-1 N In ID ry �-i N Ill rl N .-i N rl d r-I N Ln d O N O ry O N O N N O d m N O ry w o O Om Oo O N N LnO ry ID O N Ln m N ~ N Ln M o M ti m Vl Vl d In O rl d m In m n N d N Vl d o 6 lD n tD W 6 n ID ry ID cc rt1 lD ^ n �-1 1A N OD o n o l0 a0 ^ m M O '� ry m W N O '"I nj m W N O '""I N m m N O N N m m N O N N m od In o O N N m W vl m ti m m N ^ d n N � n W Vl 00 P ry � � O~D N w n In n In w ry o n W VMl w Ono d Lq m udl N O N Ol m .y N O N m M ti N O N fP1 .-1 N O N N m M .--I N o N m M .-I N O d LA Ol 7 yd n Q tp N n 1nD a O d j� n OO M Op d OO O m N O m n n OO f co:) 0o Oo n m m OR O n m E N �-9 N N m m .--1 N r-I N N m M rl n ry m ,aO.I n ry m !nIl rd-I n ry '^ m l� .di n o ^� m m f�tl Ln W N N N r-I N N �-i N m N .� N � C H m ry N ry 01 (nIl ry O N Vry1. 01 M ti N N N Ol rnn d ry M try Di ,dy N OM N Qi d n O N to W d V C .-I '� .O 3 ry n m m d W In m d Ol n m w o d m d m In Ooo oc In m M ID ri 00kD M Ol O ID n M n lD M M ID 00 O m n O lV n .-I d n N fY1 x Q O M O N W m d mm O ry W m .V7. O '� N Il0 O ^I N OO O ry N W m vl M O N ry w d m O m U3 m '. 9 cOl lm0 m M In M O N ^ fy m tp lfl lfl m to e-1 M ID n n d m N Vl Vl n .-I M tD n n O Ill d ID Oo W y O C . !p O N N 0p m .-I N O N N OO m .d-I N O ry N M d N O N N m .d-I N O N N t>D M .d-I Q ry ry d co O) O Iu n ID m vl rry+l ^ Ip m d M ID vl M ul Oo m tNn L9 m ry w o W m In d O d ID In N O N 1V m .-i O N ry OO M ry N N OO m .d-I N e-1 ry N I%7 m a ry O N ry OO m �d-1 N O N N Ib m 'y L N N O N O m N O ry N M VrI Ory0 O ry N Oo m d O M N OO M .d-I N O O rmil m N d W O N O ~ LQ lD N In 00 '-I 0o M N ID n rl tq V ID N rl Vl Ln ~ ^ lD ti lD N n O n M O N a -0 '"1 rj n N d m 0 `� N n O d O N N n a') ,I O ^I ry n N m O M N n o Ip N 0o d M Inn In d a0 N n o o ID O tD oo m m d m m o In O n m O n N N O N N n N m m ry n N .mi O N ^ m v o n N O n m m o n N 0 m d o w N r-I an d N O N m o N N M o N N '-I M O N n N '� m o N n N rl n ao ntD o ' m m mmdpu! m my doed n mommLnrl ID tDo O mnmo Inm N O N N n m m N ^ m m Oj O ry O n m m Oj O N .--I m M Oj O ry •--I W N O N N O N N .-I N �-1 N N .-1 N ry n N .-I n N m d Oo n w Ln m N n o w o ,-I d O o m O ID m Ill O m o d N o O N w Ill O d o N O N N n N .-1 ry O ry ry n N m Oo ID W N Vl ID oo .-f N m Ol ID ID d In a0 DOl Oo to ID n m n pp ^ ti ID ry Dl ID OO l. '� al ID O OO m n ti m n LDD. m y M O '� .� tD tll m ai t~ll O '� ,..j ID In m m O '� IO lD m O ^� .-+ ID N .m-I m O N '-I ID tD m IN+1 O ^l tD tD m N D? Q N In ry m N n w ID d 'y In N m IO N d O oo m 1O 01 ci ry Vl N p IO N 00 Vl m n O 00 to M O n lD 00 1f1 m p n 111 oO lD N M M d m IO n d C N O r4 .-I m o rl N .-I M O ,y tp N .� m O ry .-i O N ti M O N ri tD N .-I M p ry ,--i IO N M c to ID O d 'D Oo m tD m Op tD tD m d m In d 0o N Oo tl0 '-I m .-I N 0 N •--� ry O ry ID N ry m w ry w tU In N m Ol N O� lD Ln mm O m n m lD In m D N O r-1 N .--1 ry � t0 ry ...I M O ry N lD N � to O n Oo N o In m O m tD N O O o tD N .-I I)0 0. O ID w in ID m W In .. w V O m w m w n O O E H N .'-I N 0-o lD ry r-I O N lD ry rrvl N N 1p N N N O m Ip N N N O O w m O N lD ry N H y � E Q = o g v� a 3 Q= o - ~a 3 Q= o a 3 a= o ~a 3 Q= o t ~a E o o v Q `o LAQ Ln v W n S O n g p n OO ~ ~ Oo N c 3 O N � O w ca W L O] Ib O SS-ASXH3 www.amana-hac.com 9 £HXSd-SS wo:)•:)ey-euewe•mmm OI ? o T m M N o d � a M 0 = W N O W N O £ as O O O O O O U o x 3 n E 0 3 D v 3 0 3 D n o ? D v o = D >r v 3 0 ? D v 5 ro o �� Dim � � m � � m z z� � � m z� � � m D � a: N l N N O W N O W N O W V fJ !`� O W N O W In O O N W w , A lO lD N A w L N to N VN1 J ? In O O N tD 0 LP N In O N Q\ N to W N N w P 3 a- Ln N w W O w �+ Ol I-+ 1-� V A W in A tD W V IN �' (n F+ 00 0) w c V N 01 OO N N O N 01 J N N O N N N J N W 01 N O1 00 N v 001 W N 8 J N pVp 10/1 W N LN J N W d !0 Oi V O w �' A O O W W N co w V 1-+ W N Ch F+ O A ti, O tr COJ w %D J W -4 lO ti. O N C S ID W O1 J N ~ Q1 �I N MJ N V w N N N N A O1 N O1 OO N V A J N Q1 �! N V A W Owl 01 O W l0 w V V W N tD N tD 00 O1 lO wO O W N W W O w W 0D O N w P Ot OD Cl W 00 V 01 N d W Ol 00 N V O W W Q1 OD N V O W W Ol A J O , A In V N V O V r r r r r . r r . r r . r . J W 01 D A A p A V w tD N Ol A 00 V A V w w W O. C V W N N O !n W wN N O W N wN N O P W O N V O N W 1D N V O w O A N lO N N O ?(� 'S. N O 1"' tD w N Al W �' tD A 0 0 10 MO J V W N O N tD W N V tO I' lD W lD w O1 O V V 00 w O ID W 1p N N O tW W W n V N N O tWn N lD N N p Op�� W F+ W W N V P tWn W W tD N V O IWJI W wW N I-+ P A O 2 A N V tD V Ln V W V 00 N W In O O V W A 00 A V W J N J W O �' tD J O A O V O V W Fes+ co N V to y V W lD N V O W V W lO N V O W V N 1p N N O W V W lD N V O W V W w N V O W V N 1p N V lwll w 0 A Ot W O A Ln a`t w t0 ? In w 0 A A W O A A W W A w A V W �' tD V 00 01 N 00 tD In A W O 0O O tD V W lD W 00 _4 U1 N �' Co A 01 In W tD O cn J tD A O W N 1-� O W P O w N I-� O W w 0 w Al F O J N V N to A In V O1 N In p A w W ti. 6 01 p r r r r r , , r r V .W W N 00 V W V N V W V W V N V W F. tN V N O W V W V N O W V W V N O W W A O v w 0 A W A O J A 0 A W W O j W O W W A O J t J A W A O v 0 V A W W 0 'J N 01 W tD W to OD O w Oo N A J O Ln LD w to O A ID W In w N w 00 N A V O O w tD w to - A N T w V N O W V W V N O w V W V N O W V W V N O W V w V N O W V W V N O W m d A A 01 J A W A O J N v A W A O J A I A A O v J pp1� A W A O v A w A V VI w Z m O A p 0o J 0o W ? J to In V O W to ini0 O A in 00 A 00 IO W A J N 'tn V O W In W iD FCL W O a c F. W V N O W w V N O w Fa W V N O w V W V N O W V W V N O W V W V N O W y A A O V 00 to p p O v W to p p O J p N In A A G V p w In A A O J p A In A _ O v p A O w CD A J A 0o N to A J N (nO N W Ln W O W Ot ? J F+ 00 N to P V tD 01 O W to O tD G O O p ~ lwft O O A A ID D N 1-+ O v A A O N I-+ O Pr r r r r p D D W A N A J N w W W N N N A A M F T F� W W N F+ w W N w W w � W V F+ N I-r W � w V I-+ N W F� W N O W N ? W ID t00 W O 0o w 0000 O A O A O] 0 p A P CO 0 0 A co 0 0 In A Oo V O 00 O In �' A co O1 O lD OD lD lD O V w J lD 00 O �' A 00 M W 10 D W O A tWD I� 0 w A W ►' pW N V O W A W !' O w m ^i A 0Wo 1� p J w .~A 0Wo r p w A OWa �' W �' a m O W tD w N N 10 Op O V O N 0+ J Ot 00 A rn tD tD t0 m N to 0o 00 00 A O - to oo Ot to w m O W N W O W W V W O W V W V W O W V W N W O W V W N W O W V W N W O W N T D OVG m A A w 1-+ 0 C. A w 1-+ NO W W P tD I--� O to w P P W 7C co 0o O1 w Oo O Oo 00 01 O V V 01 A A 1-' 00 OD W w Oo O OD 00 F+ O J J 0) N A T0 Ln tW0 A (P W F. A In W W P - W p In O I-+ N 01 A O r r r O N tD -4 00 p V W V W V p V W V W V A V W V W V A V W V W p W V w V A W V N O 00 In W W O 0o tAD J W A W O O A w w A N 0 0 to W W C, tip 0 0 A W W P ip 0 0 A w W P FN.. O tD A A W 1... 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N 01 W W N WO A tD O h+ J N O A A w W A O to �+ N 1� 0o J O A W 00 O Ol O 00 N W W NJ 0 0 Ol '. � Ir — 1-+ In N 01 N 1-+ In 1-' to N O1 N 1-+ In 1-+ lA A/ m h+ A 01 m - In I-' to 1-• In N W V A �! ut J O w V A J in oo O !' rn W T in p 0 V p to W O N J A J L p O O T w N Oi N W O lP f+ OD O O N N O O1 O W J O t0 N O N A A A N 00 O i-+ O O O O m O A N to O0 F+ O v N O N 00 A N 01 w W N O In �-' to N (n p� N !n Ln N 01 In �' to N In f t+ l0 W O W p J Q1 N 01 p W N �A+ J .QO' 1'' 10 00 J 0�0 A In -An J to , N O 8 J , N O P O N 00 to W O J N In w Ot O N N lD tD O O O J (YNOD) d33+*Vt,I96PI*VDI*dOT09NEHXSV— dldp 9NI700D 030NVdX3 PERFORMANCE DATA ASXH3N1810A'/CA*FA1818*6A* ASXH3N2410A*/CA*FA2422*6A* CONDITIONS:80'F IBD,677 IWB @ 600 CFM CONDITIONS:BO'F IBD,67'F IWB @ 725 CFM OUTDOOR TOTAL SENSIBLE LATENT TOTAL OUTDOOR TOTAL SENSIBLE LATENT TOTAL TEM.*F. BTU/H BTIJ/H BTIJ/H WATTS TEM.'F. BTLI/H BTIJ/H I BTU/H WATTS 75 18,450 13,900 4,550 1,270 75 24,450 17,350 7,100 1,670 80 18,250 13,750 4,500 1,340 80 24,150 17,150 7,000 1,760 85 18,000 13,550 4,450 1,400 85 23,850 16,900 6,950 1,850 90 17,600 13,250 4,350 1,480 90 23,350 16,550 6,800 1,950 11 I 1 :11 11iiiiiiiiiiiiIwllv I 1 100 16,750 12,600 4,150 1,630 100 22,200 15,750 6,450 2,160 105 16,250 12,250 4,000 1,710 105 21,550 15,250 6,300 2,270 110 15,800 11,950 3,850 1,810 11 220,950 14,850 6,100 2,400 115 15,350 11,600 3,750 1,900 115 20,350 1 14,450 1 5,900 2,530 NA CONDITIONS @ 95'OD DO,75'ID DO 63'ID WS TVA CONDITIONS O 95'OD DO,75'ID DO 63'ID WB 95, 16,600 13,000 3,600 1,550 95, 22,000 11,850 10,150 1,540 ASXH3N3010A*/CA*FA3626*6A* ASXH3N3610A*/CA*FA4226'6A* CONDITIONS:80'F IBC),67'F IWB @ 1105 CFM CONDITIONS:80'F IBD,67'F IWB @ 1270 CFM OUTDOOR TOTAL SENSIBLE LATENT TOTAL OUTDOOR TOTAL SENSIBLE LATENT TOTAL TEM.'F. 13TU/H I3TU/H BTLI/H WATTS TEM.'F. I I3TU/H I BTU/H BTU/H I WATTS 75 30,250 22,650 7,600 2,100 75 36,650 27,250 9,400 2,480 80 29,750 21,650 8,100 2,210 80 36,200 26,900 9,300 2,630 85 29,200 20,600 8,600 2,320 85 35,750 26,550 9,200 2,770 90 28,700 20,900 7,800 2,450 90 35,000 26,000 9,000 2,930 I's I 'I � :II 100 27,400 20,550 6,850 2,720 100 33,250 24,700 8,550 3,250 105 26,600 19,950 6,650 2,860 105 32,300 24,000 8,300 3,420 110 25,900 19,450 6,450 3,030 110 31,450 23,350 8,100 3,630 115 25,200 18,900 1 6,300 3,190 115 30,550 22,700 7 850 3,830 NA CONDITIONS @ 95'OD DO,75'ID DO 63'ID WB NA Conditions @ 95'OD DO,75'ID DO 63'ID WB 95' 27,200 17,800 9,400 2,070 95, 33,000 25,500 7,500 3,080 18 www.amana-hac.com SS-ASXH3 PERFORMANCE DATA ASXH3N4210A•/CA'F4961"6A• ASXH3N4810A'/CA'F4961'6A' CONDITIONS:80'F IBD,67'F IWB @ 1460 CFM CONDITIONS:80'F IBD,67'F IWB @ 1640 CFM • • •. SENSIBLE LATENT TOTAL EOUWATTS 75 42,350 30,950 11,400 2,860 75 48,250 36,100 12,150 3,330 80 41,850 30,600 11,250 3,030 80 47,650 35,700 11,950 3,520 85 41,300 30,200 11,100 3,190 85 47,050 35,250 11,800 3 710 90 40,400 29,550 10,850 3,370 90 46,050 34,500 11,550 3,920 95 39,500 28,850 10,650 I III •I �• 100 38,400 28,050 10,350 3,760 100 43,750 32,750 11,000 4,350 105 37,300 27,250 10,050 3,960 105 42,500 31,800 10,700 4,580 110 36,300 26,500 9,800 4,200 110 41,350 30,950 10,400 4,850 115 35,300 25,750 9,550 4,430 115 40,200 30,100 10,100 5,120 TVA Conditions 95'OD D8,75'ID DB 63'ID WB TVA Conditions 95'OD DO,75'ID DO 63'ID WB 95' 38,100 28,950 9,150 3,S60 95' 43AOO 33,800 9,600 4,230 ASXH3N6010A'/CA'T4961'4A' CONmnoNs:80'F IBD,671 IWB @ 156S CFM OUTDOOR TOTAL SENSIBLE LATENT TOTAL 75 57,900 39,500 18,400 4,130 80 57,200 39,050 18,150 4,390 85 56,450 38,550 17,900 4,640 90 55,250 37,700 17,550 4,910 �•/ 36,850 17,150 5,180 100 52,500 35,850 16,650 5,490 105 51,000 34,800 16,200 5,800 110 49,650 33,850 15,800 6,160 115 48,250 32,900 1 15,350 6,510 TVA Conditions @ 95'OD DO,75'ID DO 63'ID W8 95' 52,050 36,950 15,100 S,190 SS-ASXH3 www.amana-hac.com 19 WIRING DIAGRA M \ - - � . ] ' } §%) ; ;§! . ■ §2�� m®9 |z$k §k( §§] inzWCLW 2Z 0 w/e§G§:E2 §k - , ,� /§ ` !I °�AIm����d [_ z _nm�_� _ ! o» R — — — (@% _ ( . ( »: §k L) EL 10 \{ m �j \ `=� 8wk } - §�!/ - § [! z (§])§)$|ƒ§t)k)) \ / = m� k;���k m f , |" #/§2 2ƒ§ k))�a§k9(e= 9 )k/ £qo �m !!:2l;{ )§k\ j§k }«i}\}ig�} \ }\ &! + - -- °� 0 \ wo , {§ | ` ■ f ■ ac =j ` � 2 ©! ■ � � ■ - , 1 _ | f;f � eb J*i § _ CH5 K} 20 _«,maah»em ss«+2 DIMENSIONS DIMENSIONS MODEL ASXH3N1810A' 26 26 27 ASXH3N2410A' 26 26 32% ASXH3N3010A` 29 29 32% w ° ASXH3N3610A' 29 29 32% 1� ASXH3N4210A' 29 1 29 1 39% / ASXH3N4810A' 35Y2 35Yz 35Y ASXH3N6010A" 35Y: 35Y: 39% H ACCESSORIES Model Description ABK-20 Anchor Bracket Kit A X X X X X X X ABK-21 Anchor Bracket Kit A ASC-01 Anti-Short Cycle Kit X X X X X X X CSR-U-1 Hard-start Kit X X X X CSR-U-2 Hard-start Kit X X X X CSR-U-3 Hard-start Kit X X FSK01A' Freeze Protection Kit X X X X X X X LSK02A' Liquid Line Solenoid Kit X X X X X X X LAKT01 Low-Ambient Kit X X X X X X 0130R00000S Low-Pressure Switch Kit X X X X X X X TXV-FX-KX-2T' TXV Kit X X TXV-FX-KX-3T' TXV Kit X X TXV-FX-10(-5T' TXV Kit X X X ° Contains 20 brackets;four brackets needed to anchor unit to pad ' Installed on indoor coil ' Condensing units and heat pumps with reciprocating or rotary compressors require the use of start-assist components when used in conjunction with an indoor coil using a non-bleed thermal expansion valve refrigerant metering device or liquid line solenoid kit.The TXV should always be sized based on the tonnage of the outdoor unit. All AHRI system ratings are accessible in the System Configurator tool via PartnerLink. SS-ASXH3 www.amana-hac.com NOTES 22 www.amana-hac.com SS-ASXH3 Project Name: Patricia Walker Address: 454 North Ridge Street, Rye Brook, NY OUTDOOR DESIGN CONDITIONS Weather station:White Plains, Westchester Co.AP Summer Outdoor F: Summer Indoor F: ® Design Grains: Daily Range: Winter Outdoor F: MIM Winter Indoor F: Cooling RH: t Elevation (Ft): LOAD CALCULATION TOTALS HVAC System:Amana Heated square footage: 111IMM- Heating BTUH: �. Cooled square footage: Emi'. Cooling BTUH: Heated volume (above grade CF): t CFM: Cooled volume(above grade CF): Sensible cooling: Exposed wall area(SF): offin-A Latent cooling: mom SHR: Load Calculation Cooling Heating 0 50,000 100,000 150,000 BTUH Approved ACCA MJ8 Calculations Calculations are based on the ACCA Manual J 8th Edition and are approved by ACCA. All computed calculations are estimates on building use, weather data, and inputted values such a R-Values, window types, duct loss, etc. Equipment selections should _ meet both the latent and sensible gain as well as building heat loss. HEATING AND COOLING LOADS HEATING LOADS Heating Loads aboveGradeWalls SECTION AREA HEATILOSS windows 10.2% aboveGradeWalls 2,424.8 13,642 �,/�, -" 22.4 �# l ceilings ceilings 3,946A 8,698 6.5% ducts 0 31,845 ducts floors 3,946.4 26,194 infiltration 23 8' infiltration 0 23,717 11,1% skylights 0 0 floors windows 594 29.973 `9 Totals 134,069 COOLING e. Cooling Loads aboveGradeWalls SECTION AREA SENSIBLE LATENT AEDExcursion 0 0 0 windows appliances a - r+a� aboveGradeWalls 2,424.8 4,492 0 29"5`k" 4.1%, ceilings appliances 0 2,400 0 occupants 11410 u ceilings 3,946.4 6,748 0 infiltration ducts ducts 0 12,438 2,002 --------- 10.6'io 24 dolo floors 3,946.4 4,424 0 floors infiltration 0 2,316 3,936 7 5% occupants 0 1,380 1,200 plants 0 0 300 skylights 0 0 0 windows 594 17,444 0 Totals 51,643 7,438 FENESTRATION LOADS AED Graph(mid-summer) 30,000 = 20,000 i m 10,000 0 8 9 10 11 12 13 14 15 16 17 18 19 — BTUH — Average Average 1.3 This graph represents hourly aggregrate fenestration loads in mid-summer. AED graph(fall) 20,000 10,000 m 0 8 9 10 11 12 13 14 15 16 17 18 19 — BTUH — Average , Average' 1.3 This graph represents hourly aggregrate fenestration loads in October. COMPONENT LOADS ABOVE Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 128-0s w Exposure: N Heating BTUH: 318 insulation, Stucco or Siding. U Value: 0.097 Area: 56.6 Cooling BTUH: 105 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: NE Heating BTUH: 211 U Value: 0.097 Area: 37.5 Cooling BTUH: 69 insulation, Stucco or Siding. Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: NE Heating BTUH: 1,004 insulation, Stucco or Siding. U Value: 0.097 Area: 178.5 Cooling BTUH: 331 Map trace wall Frame Wail, Wood framing, R-11 cavity Construction nr: 1213-Os w Exposure: NE Heating BTUH: 1,812 insulation, Stucco or Siding. U Value: 0.097 Area: 322.1 Cooling BTUH: 597 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: SE Heating BTUH: 314 insulation, Stucco or Siding. U Value. 0.097 Area: 55.8 Cooling BTUH: 103 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: SE Heating BTUH: 770 insulation, Stucco or Siding. U Value: 0,097 Area: 136.8 Cooling BTUH: 253 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: SE Heating BTUH: 1,589 insulation, Stucco or Siding. U Value: 0.097 Area: 282.5 Cooling BTUH: 523 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: SE Heating BTUH: 1,047 insulation, Stucco or Siding. U Value: 0.097 Area: 186.1 Cooling BTUH: 345 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: S Heating BTUH: 25 insulation, Stucco or Siding. U Value: 0.097 Area: 4.5 Cooling BTUH: 8 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 1213-0s w Exposure: SW Heating BTUH: 1,354 insulation, Stucco or Siding. U Value: 0.097 Area: 240.6 Cooling BTUH: 446 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: SW Heating BTUH: 1,338 insulation, Stucco or Siding. U Value: 0.097 Area: 237.8 Cooling BTUH: 441 Map trace wall Frame Wall, Wood framing, R-11 Cavity Construction nr: 12B-Os w Exposure: SW Heating BTUH: 535 insulation, Stucco or Siding. U Value: 0,097 Area: 95.1 Cooling BTUH: 176 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: NW Heating BTUH: 913 insulation, Stucco or Siding. U Value: 0 097 Area: 162.3 Cooling BTUH: 301 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12B-Os w Exposure: NW Heating BTUH: 893 11 V.1-- n n47 Ar— 1CIA A r 1inn RTI IH 994 ABOVE Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 12BOs w Exposure: NW Heating BTUH: 822 insulation, Stucco or Siding. U Value: 0.097 Area: 146.1 Cooling BTUH: 271 Map trace wall Frame Wall, Wood framing, R-11 cavity Construction nr: 1213-0s w Exposure: NW Heating BTUH: 696 insulation, Stucco or Siding. U Value: 0.097 Area: 123.7 Cooling BTUH: 229 BELOW There are no components for this section. Default small windows for wall Id 4433175 Construction nr: 1 G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated, Clear glass. Area: 6 Exposure: N SHGC: 0.67 Cooling BTUH: 97 Default medium windows for wall id 4433175 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Exposure: N2 SHGC: 0.67 Cooling BTUH: 195 Default small windows for wall id"32918 Construction nr: 1G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Area: 12 Exposure: NE SHGC: 0.67 Cooling BTUH: 239 Default small windows for wall id 4433173 Construction nr: 1 G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated, Clear glass. Exposure: 6 SHGC: 0.67 Cooling BTUH: 120 Default medium windows for wall Id 4433173 Construction nr: 1G U Value: 0.87 Heating BTUH: 1,$17 Window, NFRC rated, Clear glass. Exposure: NE SHGC: 0.67 Cooling BTUH: 736 Default small windows for wall id 4433177 Construction nr: 1G U Value 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Area: 12Exposure: NE SHGC: 0.67 Cooling BTUH: 239 Default medium windows for wall id 4433177 Construction nr: 1 G Area: 24 U Value: 0.87 Heating BTUH: 1,211 Window, NFRC rated, Clear glass. Exposure: NE SHGC: 0.67 Cooling BTUH: 491 Default large windows for wall id 4433177 Construction nr: 1G U Value: 0.87 Heating BTUH: 1,817 Window, NFRC rated, Clear glass. Area: 36Exposure: NE SHGC: 0.67 Cooling BTUH: 743 Default small windows for wall Id 4432915 Construction nr: 1G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated, Clear glass. Exposure: SE SHGC: 0.67 Cooling BTUH: 206 Default medium windows for wall id 4432915 Construction nr: 1G U Value: 0.87 Healing BTUH: 606 Window, NFRC rated, Clear glass. Area: 12 Exposure: SE SHGC: 0.67 Cooling BTUH: 426 Default small windows for wall id 4432917 Construction nr: 1G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Area: 12 g Exposure: SE SHGC: 0.67 Cooling BTUH: 413 Default medium windows for wall id 4432917 Construction nr: 1 G Area: 24 U Value: Window, NFRC rated, Clear glass. 0.87 Heating BTUH: 1,211 Exposure: SE SHGC: 0.67 Cooling BTUH: 852 Default small windows for wall id 4433178 Construction nr: 1 G Window, NFRC rated, Clear glass. Area: 6 U Value: 0.87 Heating BTUH: 303 Exposure: SE SHGC: 0.67 Cooling BTUH: 206 Default medium windows for wall id 4433178 Construction nr: 1 G Window, NFRC rated, Clear glass. Area: 24 U Value: 0.87 Heating BTUH 1,211 Exposure: SE SHGC: 0.67 Cooling BTUH: 852 Default large windows for wall id 4433178 Construction nr: 1G Window, NFRC rated, Clear glass. Area: 36 U Value: 0.87 Heating BTUH: 1,817 Exposure: SE SHGC: 0.67 Cooling BTUH: 1,292 Default small windows for wall id 4433180 Construction nr: 1 G Area: 6 U Value: 0.87 Heating BTUH: 303 Winrtnw NFRC ratwri Cesar nlaqc .,Hr:r. n 97 rnntinn RTI IH• 9M, Default medium windows for wall id 4433180 Construction nr: 1 G Area: 36 U Value: 0.87 Heating BTUH: 1,817 Window, NFRC rated, Clear glass. Exposure: SE SHGC: 0.67 Cooling BTUH: 1,278 Default small windows for wall id 4433179 Construction nr: 1G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated. Clear glass. Exposure: S SHGC: 0.67 Cooling BTUH: 189 Default small windows for wall id 4432916 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Exposure 12 SHGC: 0.67 Cooling BTUH: 444 Default medium windows for wall id 4432916 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Exposure: Sw SHGC: 0.67 Cooling BTUH: 454 Default large windows for wall id 4432916 Construction nr: 1G U Value: 0.87 Heating BTUH: 1,817 Window, NFRC rated, Clear glass. Exposure: sw 36 SHGC: 0.67 Cooling BTUH: 1,373 Default small windows for wall id 4433181 Construction nr: 1 G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated, Clear glass. Exposure: 6 SHGC: 0.67 Cooling BTUH: 222 Default medium windows for wall id 4433181 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC ratea, Clear glass. Area: 12 Exposure: SW SHGC: 0.67 Cooling BTUH: 454 Default large windows for wall id 4433181 Construction nr: 1G U Value: 0.87 Heating BTUH: 1,817 Window, NFRC rated, Clear glass. Area: 36 Exposure: SW SHGC: 0.67 Cooling BTUH: 1,373 Default small windows for wall id 4433183 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Area: 12 Exposure: SW SHGC: 0.67 Cooling BTUH: 444 Default medium windows for wall Id 4433183 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Area: 12 Exposure: SW SHGC: 0.67 Cooling BTUH: 454 Default small windows for wall id 4433172 Construction nr: 1 G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated, Clear glass. Exposure: 6 SHGC: 0.67 Cooling BTUH: 141 Default medium windows for wall id 4433172 Construction nr: 1 G U Value: 0.87 Heating BTUH: 1,817 Window, NFRC rated, Clear glass. Area: 36 Exposure: NW SHGC: 0.67 Cooling BTUH: 865 Default small windows for wall id 4433174 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Area. 12 Exposure: NW SHGC: 0.67 Cooling BTUH: 283 Default medium windows for wall id 4433174 Construction nr: 1G U Value: 0.87 Heating BTUH: 1,211 Window, NFRC rated, Clear glass. Area: 24 Exposure: NW SHGC: 0.67 Cooling BTUH: 577 Default small windows for wall Id 4433176 Construction nr: 1 G U Value: 0.87 Heating BTUH: 606 Window, NFRC rated, Clear glass. Exposure: NW SHGC: 0.67 Cooling BTUH: 283 Default medium windows for wall id 4433176 Construction nr: 1 G U Value: 0.87 Heating BTUH: 1,211 Window, NFRC rated, Clear glass. Area: 24 SHGC: 0.67 Cooling BTUH: 577 Exposure: NW Default small windows for wall id 4433182 Construction nr: 1 G U Value: 0.87 Heating BTUH: 303 Window, NFRC rated, Clear glass. Exposure: 6 SHGC: 0.67 Cooling BTUH: 141 Default medium windows for wall id 4433182 Construction nr: 1G U Value: 0.87 Heating BTUH: 1,211 Window, NFRC rated, Clear glass. Area: 24 SHGC: 0.67 Cooling BTUH: 577 Exposure: NW Window cooling BTUHs shown here are daily average values. See AED graphs for details of fenestration loads during the day. Map trace generated ceiling Geihny under attic of attic knee wall,Asphalt Construction nr: 16B-25 ad Area: 3,946.4 Heating BTUH: 8,698 shinoles. Dark. R-25. There are no components for this section. Skylight cooling BTUHs shown here are daily average values. See AED graphs for details of fenestration loads during the day. There are no components for this section. Map trace generated floor Floor over enclosed unconditioned crawl space Heating BTUH: 26,194 Construction nr: 19A-0cp Heating U Value:0.295 4,Cooling BTUH: 424 or basement, no floor insulation, Carpet or Area: 3,946.4 Cooling U Value:0.295 F Value: hardwood. VENTILATION There are no components for this section. HOT WATER PIPING There are no components for this section. System generated ducts(below conditioned space) EHLF: 0.133 Heating BTUH: 13,610 Unconditioned Basement- Radial ESGF: 0.095 Sensible BTUH: 3,722 ELG: 1,278 Latent BTUH: 1,278 System generated ducts(above conditioned space) EHLF: 0,178 Heating BTUH: 18,234 Attic-Radial ESGF: 0,222 Sensible BTUH: 8,717 ELG: 724 Latent BTUH: 724 INFILTRATION Leakage Category: Loose NCFM Heating: 376 Heating BTUH: 23,717 NCFM Cooling: 178 Sensible BTUH: 2,316 Latent BTUH: 3,936 BLOWER • •' There are no components for this section. WINTER HUMIDIFICATION There are no components for this section. OCCUPANTS Nr.Occupants: 6 Sensible BTUH: 1.380 Latent BTUH: 1,200 APPLIANCES Standard kitchen and utility room,lighting:2,400 BTUH Quantity Sensible BTUH: 2,400 Latent BTUH: Plant Size: small Quantity: 5 Latent BTUH: 50 Plant Size: medium Quantity: 5 Latent BTUH: 100 Plant Size: large Quantity: 5 Latent BTUH: 150 ROOM DETAIL Room name: st floor Heated square footage: Total Cooling BTUH: t Cooled square footage: Total Heating BTUH: t. Heated volume(above grade CF): CFM: Cooled volume(above grade CF): Exposed wall area(SF): Load Calculation Cooling Heating 0 50,000 100,000 150,000 BTUH AED Graph (mid-summer) 30,000 = 20,000 m 10,000 0 8 9 10 11 12 13 14 15 16 17 18 19 — BTUH — Average Average" 1.3 AED graph (fall) 20,000 ti 10,000 m 0 8 9 10 11 12 13 14 15 16 17 18 19 — BTUH — Average Average 1.3 Tax Parcel Maps Address: 454 N Ridge St Print Key: 129.60-1-33 SBL: 12906000010330000000 A-31 4 454 N Ridge St '29 60-1-33 �\ Pool 33 454 N Rig;� '29 60.1.3`, -S-4 I. Ridge St FO-1-33 �W Disclaimer: This tax parcel map is provided as a public service to Westchester County residents for general information and planning purposes only,and should not be relied upon as a sole informational source.The County of Westchester hereby disclaims any liability from the use of this GIS mapping system by any person or entity.Tax parcel boundaries represent approximate property line location and should NOT be interpreted as or used in lieu of a survey or property boundary description. Property descriptions must be obtained from surveys or deeds. For more information please contact the assessor's office of the municipality. 1::Y^E'.�Kt�,f�A '�ik?,;.c:Ls:, ;?.G''+ .;�%c:• <;( ��.C, $ ,n � r 1 ;i�?cgr •Y... .A : ,fir yy t':T. i:.4;n � -r'n �, h: y i ,11,..� ?y,. -rr'ra fN{"+a:�1.r.•� ,fir` e,, � U••Ali '!:.f. C� .t+yjfiK?��•ti Y,� ..�/�r Ji�f'. �: 1 ,,�! ..'.. ;;ti ,�"�;j•. `' •'�1::.. 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A� CERTIFICATE OF LIABILITY INSURANCE DA 11/13/D,YYYYI 1/13/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(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 endorsements. PRODUCER NAME:IT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 A CNNo Ext:888-333-4949 FAX No):5074464664 OWATONNA, MN 55060 ADDRESS:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 287-972-4 INSURER B: BRUNI AND CAMPISI PLUMBING AND HEATING, INC. INSURER C: 100 GRASSLANDS RD ELMSFORD, NY 10523-1110 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:37 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 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 TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR INSR WVD MMIDDIYYYVI (MMIDD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X !OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $100,000 MED EXP(Any one person) $5,000 A Y N 6119957 01/01/2023 01/01/2024 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ❑JECT PRO- ❑LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED A AUTOS N N 6119957 01/01/2023 01/01/2024 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per acciden X UMBRELLA LAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LAB CLAIMS-MADE N N 6119958 01/01/2023 01/01/2024 AGGREGATE $5,000,000 DED X RETENTION$10,000 WORKERS COMPENSATION H- AND EMPLOYERS'LIABILITY y I N PER STATUTE OER T ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT OFFICERIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE It yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 287-972-4 37 0 VILLAGE OF RYEBROOK 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 © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:DCB22B4E-5D9E-4960-8FA3-D7C23886CCED NTW Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1..Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured BRUNT AND I PLUMBING AND HEATING, 100 Grasslandsds Rd 1c.NYS Unemployment Insurance Employer Registration Number of Rd ELMSFORD,NY10523 Insured Work Location of Insured(Only required if coverage is specifically limited to Id.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 132999646 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Indemnity Insurance Co.of North America VILLAGE OF RYE BROOK 938 KING STREET 3b.Policy Number of Entity Listed in Box"la" RYE BROOK,NY 10573 C51623769 3c.Policy effective period 10/1/2022 to 1010112023 3d.The Proprietor,Partners or Executive Officers are 0 included.(Only check box If all partners/officers Included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box 'S'insures the business referenced above in box"1a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy).The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder,This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to he named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that 1 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: Lex Smith E�, cus�ttrrame of authorized representative or licensed agent of insurance carrier) Approved by: 9/12/2022 (Signature) (Date) Title: A5si5tant ProgrAm Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 214-721-6248 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) Accl#:2600046 www.wcb.ry.gov