HomeMy WebLinkAboutElevator Inspection 2023-8-6 Elevator Inspection Report Enclosed
D EC E NE
AUG 10 2023
VILLAGE OF RYE BROOK
GOTHAM
BUILDING DEPARTMENT
ELEVATOR •
Data Processing Center
650 Halstead Avenue, Suite 106
Mamaroneck,NY 10543
August 6, 2023
Village of Rye Brook
Department of Buildings
938 King Street
Rye Brook, NY 10573
RE: Elevator Inspection QEI Report for 17 Berkley Dr.
Enclosed please find our 2023 QEI reports for the inspection of the elevators/escalators
located.
at the above referenced location.
Sincerely,
Tara Rooney
Gotham Elevator Inspection
Data Processing Center
650 Halstead Avenue, Suite 106
Mamaroneck, NY 10543
p 914 835 1010
f 914 835 0084
trooneji gotliamelevatorinspectioat.corn
QEI Elevator Inspection / Test
Report
Inspection
1 Location Information
F,ddless 17 Berkley Drive Application Number(If applicable)
Town Rye Brook Speed 30 fpm Capacity 750 Ibs
2 1 Report Type 3 Fee Status
®Elevator Inspection/Test J Filing Fee
[a]Periodical Test ❑ Passenger Fee Exempt with Proof Enclosed
❑Routine Inspection ❑Freight
❑Acceptance Test
4 Applicant Information To be completed by the inspecting agency.
Last Name First Name Middle Initial
Business Name Gotham Elevator Inspection Business Telephone (212)292-4225
Business Address 521 Fifth Avenue, Suite 1700 Mobile Telephone
city New York state NY Zip 10175 E-Mail tledden@gothamelevalorinspection.com
BIS Registration# Agency Certification# 487001 License Number 487001
5 Owner Information
Last Name Danko First Name Marty Middle Initial
Business Name Southern Westchester Boces Business Telephone (914)417-8822
Business Address 17 Berkley Dr Rye Brook, NY 10573 Mobile Telephone
city Rye Brook State NY Zip 10573 E-Mail
6 Test Information List each device individually. Device types marked with an asterisk(*)require Section 11 to be completed.
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Internal Use Only
Batch Number Date Received Fee Paid Invoice Number Accepted Rejected Reason
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QEI Inspection PAGE 2
7 Location Information Repeat information provided in Section 1
Address 17 Berkley Drive Application Number(If applicable)
8 Unsatisfactory Devices Refer to Page 3 for Elevator Part, Violation Condition,and Suggested Remedy codes.
1. Device#: QEI-1 Comments:
Elevator Part 31 31-actuating roller
Violation Condition H
Suggested Remedy 11
2. Device#: Comments:
Elevator Part
Violation Condition
Suggested Remedy
3. Device#: Comments:
Elevator Part
Violation Condition
Suggested Remedy
4. Device#: Comments:
Elevator Part
Violation Condition
Suggested Remedy
5. Device#: Comments:
Elevator Part
Violation Condition
Suggested Remedy
9 Property Owner's Statements and Signatures 11 Witnessing Agency's Statements and Signatures
The above named Approved Elevator Inspection Agency has pedonned on my behalf an As a representative of an Approved Elevator Inspection Agency.I attest to have been witness
inspect ordtest of the elevator(s)described above and on attached sheets A copy of the to the inspechon(s)Itest(s)performed by the above named inspecting agency. These
final report has been provided to me and appropriate inspection certificate(s)will be posted rnspection(s)/test(s)were performed in accordance with all NYC Administrative Code and other
in accordance with NYC Administrative Code and other applicable laws and rules applicable laws and rules I further attest neither myself nor my agency have any affiliation with
Falsification of any statement is a misdemeanor and is punishable by a fine or the above named inspecting agency. Falsification of any statement is a misdemeanor and is
imprisonment,or both.It is unlawful to give to a city employee or for a city employee to punishable by a fine or imprisonment,or both.It is unlawful to give to a city employee,or for a
accept any benefit,monetary or otherwise,either as a gratuity for property performing the city employee to accept any benefit. monetary or otherwise, either as a gratuity for properly
job or in exchange for special consideration. Violation is punishable by imprisonment or performing the job or in exchange for special consideration. Violation is punishable by
fine or both imprisonment or fine or both.
Certified Organization: Gotham Elevator Inspection
Owner's Name(print): Marty Danko
Street Address:521 Fifth Avenue,Suite 1700
Signature and Date ,
City: New York State:NY Zip:10175
10 Inspecting Agency's Statements and Signatures Telephone Number:(212)2924225 Fax: (914)835-0084
As the above named Approved Elevator Inspection Agency, I have inspecteditested the E-Mail Address:tledden@gothamelevatorinspection.com
elevator(s) described above and on attached sheets in accordance with all NYC
Administrative Code and other applicable laws and rules. The results of these inspections/
tests are indicated above and a copy of this report has been provided to the owner
Falsification of any statement is a misdemeanor and is punishable by a fine or ►
imprisonment,or both.It is unlawful to give to a city employee,or for a city employee to Signature and Date
accept any benefit. monetary or otherwise,either as a gratuity for properly performing
the job or in exchange for special consideration Inspector's Name(print):,John Fino Lic#: NAESA-#5199
Signature and Date ,
NOTE.Witnessing Agency Signatiotincit r6quired if i rng inspection results for Private Residential
Certified Organization: Slade Industries, Inc. Elevator,Conveyor,Dumbwaiter,alMatenal Lift
Inspector's Name(print):
Signature and Date ► NOTE:Hazardous Conditions/Cease Use items shall not be
reported on this form.These items shall be corrected immediately.
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QED (C1spection PAGE 3
12 Elevator Part
INSIDE CAR TOP OF CAR 51 Slack Rope Switch 77 Underside Platform
01 Emergency Stop Switch 26 Top Emergency Exit Cover 52 Hoist Cables 78 Tension Weight
02 Alarm System 27 Governor Release Carrier 53 Governor Ropes 79 Comp/Chains/Ropes/Switch
03 Car Enclosure 28 Door Hangers&Connectors 54 Car Counterweight Rope 80 Counterweight Runby
04 Side Emergency Exit 29 Door Operator 55 Drum Counterweight Rope 81 Counterweight Runby Signage
05 Car Door/Gate 30 Normal Limits 56 Hoist Machine 82 Plunger Gripper
06 Car Door/Gate Contact 31 Final Limits 57 Hoist Motor ESCALATOR/MOVING WALK
07 Door Reopening Device 32 Guide Shoes/Roller Guides 58 Worm/Gear/Bearings 83 Fire Shutters
08 Car Floor to Landing Still 33 Counterweight 59 Machine Brake 84 Skirt Switch
09 Car Floor 34 Hoistway 60 Lighting Machine Space 85 Skirt Deflection Device
10 Car Door Gibs 35 Electrical Wiring 61 Machine Disconnect SW 86 Comb Plate/Comb Plate Teeth
11 Car Button Station 36 Pipes and Ducts 62 Commutator 87 Landing Plate/Impact Switches
12 Car Lighting 37 Overhead&Deflector Sheave 63 Motor Brushes 88 Handrails/Handrail Safeties
13 Emergency Lighting 38 Traveling Cable&Junction 64 NYC Device# 89 Step/Thread
14 Car Mirror 39 Car Top 65 Unintended Car Movement 90 Key Switch
15 Certificate Frame MACHINE ROOM 66 Emergency Brake/Rope Gripper 91 Emergency Stop Button
OUTSIDE HOISTWAY 40 Machine Room 67 Communication 92 Decking and Ballistrades
16 Hoistway Doors 41 Machine Room Door 68 Maintenance Log 93 Ceiling Guards
17 Hoistway Door Gibs 42 Controller—Selector 69 Code Data Plate 94 Deck Barricades
18 Hoistway Door Reinforcements 43 Reverse Phase Relay PIT 95 Internal Safeties
19 Hoistway Door Safety Retainer 44 Traction Sheave 70 Pit 96 Safety Signage
20 Vision Panel 45 Governor 71 Pit Light ALL TYPES
21 Interlocks 46 Governor Switch 72 Pit Stop Switch 97 Entire Device
22 Parking Device 47 Drum 73 Car Guide-Rails&Brackets 98 Current Five Year Tag
23 Hall Button Station 48 Pump Unit 74 Cwt Guide-Rails&Brackets 99 Current One Year Tag
24 Indicators 49 Drum Machine Limit SW 75 Buffers 100 Miscellaneous
25 Door Safety Retainer 50 Generator 76 Car Safety&Tail Rope
13 Violating Condition
A Altered H Worn O Dirty V Not Level
B Insufficient I Damaged P No Means of Access W Unlocked
C Padlocked J Misaligned Q Unguarded X Inoperative
D Unsecured K Rusted R Illegal Y Oil Leak
E Rubbing L Defective S Not Fire Retardant Z Water Leak
F Lost Motion M Missing T Unlabeled AA Carbon Buildup
G Improper Fuses N By-passed U Device Not Tagged BB Expired Tag
14 Suggested Remedy
01 Adjust 06 Properly Secure 11 Replace 16 Provide Means of Access
02 Clean 07 Provide 12 Reshackle 17 Re-inspection Required
03 Install Guards 08 Regroove 13 Seal
04 Patch 09 Remove 14 Shorten
05 Perform&File Test 10 Repair 15 Tag Device
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