Loading...
HomeMy WebLinkAboutMP23-132PERMIT i1oCj�< SECTION TYPE OF WORK JOB LOCATION In OWNER770 ! CONTRACTOR B�EST. COSTIiiiiiiiiiiiiiiiin ✓CO Nlr� o TCO N DATE oA . 9 ecP wi nru / LOT FEE OATF FoonNG FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING ED RGH PLUMBI Ck -� GAS SPRINKLER ELECTRIC LOW -VOLT 0 ALARM 0 AS BUILT FINAL , I NSP 7) 9yo- a3 i 9c a3- v9y /ihe OTHER APPROVALS ARB BOT MIN ZBA OTHER �QyE'QR(1,�• L 190 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 BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE March 26,2024 Thomas Piller&Lisa Youkeles 12 Lawridge Drive Rye Brook,New York 10573 Re: 12 Lawridge Drive, Rye Brook,New York 10573 Parcel ID#: 129.67-1-58 Mechanical Permit#23-132 issued 9/8/2023 for a New Generator This certifies that the 20kw LP gas fired generator,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to C QR. 19 try wJ�vJ V t � J 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 BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE March 26,2024 Thomas Piller&Lisa Youkeles 12 Lawridge Drive Rye Brook,New York 10573 Re: 12 Lawridge Drive, Rye Brook,New York 10573 Parcel ID#: 129.67-1-58 This document certifies that the work done under Mechanical Permit #23-133 issued on 9/8/2023 for the installation of four 120 gallon above-ground propane tanks have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to --�'� For office use only: BUILD T. NT PERMIT# ),' 13 �L V OF RY.E WOK ISSUED: — —�3 938 KING STRE _ I YE BxatoK,, W YORK 10573 D ATE:c-T 31f 9 FEE: try PAtDJW wvlyvr APPLICATION FOR CERTIFICATE OF OCCUPANCY,CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUMITTED ONLY UPON COMPLETION OF ALL WORK AND PRIOR TO THE FINAL INSPECTION •rsu•rrrraaaas sssrarrariar►ra saraagairirgtssrsrrrrs•agara grss•rsiairasr ri srasrrrssuttts Nlttu tsNNtsUgtsta tti usa►i Address: :' n Occupancy/Use: Parcel ID#: k -7 l Z$ Zone: Owner: Address, &A C,,k-3&vZ P.E./R.A.or Contractor: ���_1FdZT4?.. �Jyh pdLAddress: Ad R :)�c t f-l' C12)le'm Person in responsible charge: Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YOM COUNTY OF WESTCHESTER as: '�I—An MCc6 pt�k f i being duly sworn,deposes and says that he/she resides at �7 (Print Name of Applicant) (No.andttreet) in !'Sr>y-' ,in the County of w � ,1;����,e in the State of ,that ityrrown village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:S 'E;1 CS3yJ for the construction or alteration of: Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn to before me this 30tl Sworn to before me this day of r , 202 1111 day of ,20 � \\I111111IIN� / v- r•�� �WAR0 T'' Signature of Property Owner r� ST�►r •��-Z Signature of Applicant Print Name of Property Owner z 'ICJ( �S%' i�\C;c� ; Print Name of Applicant c11 62� Cor. 1 Notary Public !R Notary Public S/12/2021 QyE BRC��, O� 2m BUILDING DEPARTMENT ❑BUILDING 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 : i L/A oC 1 c�7Iz CJ 2 ' DATE: PERMIT# ' ' `P J ISSUED: l` "z 3 SECT: L BLOCK: LOT: -5 LOCATION: i y s, �,-%U OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas l� ❑ FUEL TANK ❑ FIRE SPRINKLER - ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL OTHER QyE BRC��. cu � 1932 BUILDING DEPARTMENT BUILDING 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 :— 1 DATE: PERMIT#1 � l ISSUED:,-, \ SECT: BLOCK: LOT: ._ —z i LOCATION: `� �C - OCCUPANCY: ❑ Violation Noted T E WORK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION C"\C?Nv 2S— REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas J3 LP. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER s s x - s M w J N Ll, N \ -G 0 W x u x ICy \ �j N 1.y z v O a P� 0400 a, 1-0 W as papLn o o � � v a W tolz F :� [� cu " W ono fr'r O w 3 'o o Q 0 It W 1-i W o .xs C - „ pcs F 10) AQb 3-,-C a w10 oQ W � 00 W 'o+00 C-4 co tQ p a w cu di 1,2 & � -,, r'y a wA ,, 05: -'Ci :3. � O � ll n - w o �r-+ a w a �0- _ � BUILDIN ` TMENT W IE V11LL4, OF RYE` bOK ID 938 KING STiI T RYE BRO NY 10573 J U L 2 0 2023 r '4�93 -0b VILLAGE OF RYE BROOK Wes' BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: Permit# ��� � C.�" Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: ��}} Application Fee-X '� Permit Fees: 00—P6 APPLICATION TO INSTALL A PERMANENT STANDBY BACKUP GENERATOR Application dated: ( !/�V T a x-3 is hereby made to the Building Inspector of the Village of Rye Brook for the issuance of a Permit to install a permanent standby backup generator in accordance with§250-4.1.of the Code of the Village of Rye Brook,as per detailed statement described below. Please note that a and plumbing permit a lications must be filed se ratel b those licensed rofessionals,and that separate permits are required for the installation of any relat a s. Further note that all applications for commercial use will require a site plan approval from the Village Planning Board prior to the issuance of any permit`. 1. Job Address: C�J SZ v"r-"j-- Nf PS 3 2. Parcel ID#: 1 Z-q . (a-4 -- S T� Zone: 3. N.Y.State Construction Classification: N.Y. State Use Classification: 4. Proposed Generator&Fuel T e(Deseribe in detail): O V-r— Z �✓ 1�e'er P�+�4�_ ��� 5. Property Owner: ` a wA-Q S ► ��' Address: 1 Z \ Y 1 OS7 3 Phone# r Cell# R I-, Z3 VW email:-tit k �yQ •c o Applicant: Address: �'. t7 . X 1 1 C�v o+n ..dSar a5 Zo Phone# q Ik O 2ZL Cell# I%?- V Sf 5 email: V "«k ezzr' Architect or Engineer(if applicable): Address: Phone# Cell# email: General Contractor: /C �F GJ�/C L C- Address: Phone _Cell# ?f,c)- ���� email: i 611/2023 6. Give exact dimensions from proposed generator to lot fuzes: front yard: 60 rear yard: !I right side yard: left side yard: 7. If building is located on a comer lot,which street does it front on: A 8. Will the proposed project disturb 400 sq.ft.or more of land,requiring a Stormwater Management Control Permit from the Village Engineer as per Chapter 217 of the Code of the Village of Rye Brook? Yes: No: 9. Will the proposed project require a Site Plan Review by the Village Planning Board as per Chapter 209 of the Code of the Village of Rye Brook? Yes: No: , (provide detailed drawings as per Chapter 209) 10. Will the proposed project require a Steep Slopes Permit as per Chapter 213 of the Code of the Village of Rye Brook? Yes: No: (provide a detailed topographical survey) 11. Is the lot or any portion thereof located in a Wetland as per chapter 245 of the Code of the Village of Rye Brook? Yes: No:X(provide a detailed survey indicating the Wetland&Buffer Zone) 12. Is the lot or any portion thereof located in a Flood Zone as per the FEMA Flood Insurance Rate Map#36119CO279 dated 9/28/07? Yes: No: Y_ 13. Will the proposed project require a Tree Removal Permit as per Chapter 235 of the Code of the Village of Rye Brook? Yes: No: >� (a tree replanting schedule may be required) 14. Does the proposed project involve a Home-Occupation as per Chapter 250-38 of the Code of the Village of Rye Brook? Yes: No: X If so,indicate: TIER I: TIER I1: TIER III: 15. What is the total estimated cost of construction: S �,`t5(7 . (The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis) 16. Estimated date of completion: J�Z3 STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: 1�4;-�- k'-1akyvC15 ,being duly sworn,deposes and states tha e she is the applicant above named, (print name of individual signing as the applicant) and further states that is the legal owner of the property to which this application pertains, or that ( he is the nTc�C" r 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 o 1 i /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 Sworn to before me this ZV` day of �1 `^� , 20 day of c,t&Q_ , 20 Z-3 Signature of Property Owner Signature of Applicant '' 0/-1A_5 F t1~11� Print Name of Property Owner Gomm S.mom Print Name of Applicant Nebry G �.111MIC�btlgq! trPublicCando" r z Lobs Notary blic 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 theron-4:5*pk1W.St&t@ o i ed y a I' a io not properly completed in its entirety and/or not properly signed shall be dee 8 ed to the applicant. Please note that application fees ar of Hew rbtk 2 NO.0111FCV87636 Wied In W4$WheeWvNision ExpUes i2p23 �i • O M of a .�-w .00.r 0 L w \ \ Cn O Ch_I z a a .. w .� W as W Ln Z A c ao x .n > r OLr) Ln w c ►� c z w 0 � Z C7 A z � a V CIO ZO N t A U U V U w a c .a d .n V F 8 ►- U w z CL CA `` x �I a 03 oz-41 �l V41 = � t.41414141 fo 441414At4;4;C4;t4+64i414$44U44e9414494414414$4464;C BUIL 1)-E--P'AP4MENT D ' VIL E OF RYE OK 938 KIN ET RYE B rr NY 10573 JUL 2 0 2023 ID or_ VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION - Westchester County Master Electricians License Required FOR OFFICE USE ONLY -$P-w. /- �� J �� EP#: Approval Date- AUG 2 9 2023 �5Q Permit Fee: $ Approval Signature: Other: ****************** ** **************************************************************************** Application dated, �o Z$ zD2-3 is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/ r remove electrical equipment,wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. 16sz3 1.Address: k Z L-cxv,,r �� �c-:vim{ SBL: '6 Zone: 2.Property Owner: Address: rz. "—r��� Phone#: Cell#: email: tq p;�1 e ya'Lwc 3.Master Electrician/Licensed Installer: t4<c-1!'�— Address: Lie.#: t S 01 Phone#: q 1`-k-n -O LZ z Cell#: 41 y-W-L-SSI S email: h-,clL P Company Name: LL Address: r, Q. Ct sr'* oh �{v ►d �(iv��� 4.Proposed Electrical Work/Fixture Count: (Aj%Ve- 6" 11 20 KW 1�e�c_�'"v p QA.wzr�CtCDfI'" �,,.._l � ��v-Coy�Z'1��'�S£v �� ►mac 5.31 Party Electrical Inspection Agency: VrtGz(f �- e ��� _5 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 0 i41�; kakyvIckS ,being duly sworn,deposes and states th q/she is the applicant above named,and does further (print name of individual signing as the applicant), state that( is the WAase�e�ets%�V­ for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best o er knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance wi a 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 Sworn to before me this Z2� � day l 20 �-3 day of A�•� ,20 Z-3 Signature of Property Owner Si gna e Applicant �G� Print Name of Pror Owne Print Name o Applic t , Q"j dLj (4nm Y NOT Public IT- GORDON S.MCGHIE SOON$. Notary Public.State of New York Nlwy pwft,I"of New rblk NO.01MCGISTWe M0.h10111106116 awNW1 in My COmtNeaielt E>e�kee Z � © zy 3/3/2023 STATE WIDE INSPECTION SERVICES, INC CAD Service With Integrity 0:0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# .i\ 3_ 1 Date Bldg Permit#- �Of 3—�/ Sq Ft Plumbing Permit# Final Certificate# City/Village Zip 7� Building Dept. County Address ` ` Cross Street ion Block Lot C� ci Owner Name/Address(If different than above) h(�rn�`^ ^ (' Contact Number \J t ❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside esidential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground rEl NewReconnect Repair ❑Overhead Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation 40- C�� lt>1ACb �ZOVL4_) tirr D, SEP 18 2023 D�0 Q 3 53 VILLAGE OF,RYE BUILDING DEPARTFARTMEN ENT i This application is valid for one(t)year from the date received by SMS.This application is intended to cover the above listed items to be inspected,if at anytime of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address f, ) Name License# 21 Date t Signature Address , City/State { Zip Code Company ✓ Phone# —7 D l (�I�`\J�] State Wide Inspection Services (�J LI V 1080 Main Street Fishkill, NY 12524 TO � MAR 2 0 2024 1 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICtS - Email: of I ice\swisny.com VILL,4G_ OF :;Y'� BiaCOK BUII_i'in•:� i;'`F'�.RTi,�ENT Website: www.swisny.com Service W/rh Integrity - BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: NK Electric LLC Thomas Gerald Piller& Lisa Youkeles Nick Kalyvas 12 Lawridge Drive P.O. Box 171 Rye Brook, NY 10573 Croton-on-Hudson, NY 10520 Located at: 12 Lawridge Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-204 129.67 1 58 Certificate Number: 2024-0604 Building Permit Number: MP 23-132 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 12 Lawridge Drive, Rye Brook, NY 10573 The Garage and Exterior were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below, was found to be in compliance on the 1st day of February 2024. Name Quantity Rating Circuit Type Generator 01 24kW ATS 01 200AMP Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. 0000 09 S W a a z � u w O v xyn" �Q , 00 Pool 00 17 r � 0000 r.. o v ^d e c+) D\ p 00 CLLr) r- I? A u z W � ro N oG o Q . � "Rid O x o F y ON U C4. Cl) Q x o c� z Via . O CC- Lni w o z z ul , w � 7 y � 14 oo c� Z Q �-, R, a �; W • : r')14 U a a o � Is w O Z z 0.0 xr CL v� oa- � �I a a w z � i' f' BUILDING DEPARTMENT AUG 2 9 2023 1 DD VILLAGE OF RYE BROOK 938 KING ST sT RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT w v'wige 9c�#•org PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY ��' PP#: � 3- a j3z:� Approval Date: AUG 2 9 2023 Permit Fee: Approval Signature: •� Other: Disapproved: (fees are non-refundable) Application dated, Pf I I fib is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work willm be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: ( '.1- �� � l 1- � T St a— SBL: /Q /i l 7` /S<? Zone: A49 /� 2.Proposed Work: N G fl S L ' ,-,a 62 L Tom-' -rn G 3.Property Owner: Ty/✓t `Q/Address: IZ e�-� S,e UZ Phone#: Cell#: 917-- /7 0''a 3 ArF email: 4.Master Plumber: y Tr/-cz�Z Address:Py b q /5 Lic.#:�Phone#: IF14f- )-77?'0 j Cell#: email: LO/t cosy Company Name: Address: INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service I Service Sewer LP Gas Basement I st Floor 2nd Floor 3`d Floor 4'Floor 5'h Floor Exterior / I 5.*List Other Equipment/Provide Details: (Notarized Signatuzes Required Next 2 Pages) 3/3/2023 D IE C IE ME BUILDING DEPARTMENT AUG 2 9 2023 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT www.rvebrook.org _ ..__ ..._....._..__ AFFIDAVIT OF COMPLIANCE VILLAGE CODE &216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: residingat, ( Z- C/AW77,tD(.,,� --J>t'C. 1Z'e61juat4 )"Y being duly sworn,deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 2 L—��'✓ 117�C �/2 l V'�' , Rye Brook,NY. Further that all statements contained herein are true,and that to the best of his/her knowledge and belief, that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer,and further that there are no roof drains, sump pumps,or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. Itiignalunrtl'm}hrt� U��ncnai (Print\;rmc othopc)1.\ 0%knir(,)1 „rrrrrrrnrr„ '' pNORq Sworn to before me thisCD day of �Tu 20 -;- 8/12/2021 STATE r NEW YORK,COUNTY OF WESTCHESTER ) as: D43 T,,-e being duly sworn,deposes and states that he/she is the applicant above named, (prii name of individual signing as the applicant) and further states that(s)he is the Master Plumber 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 2 Sworn to before me this Z Z day of S v t-Y 20 �-3 day of J "LY 20 2 3 J - Signature of Property bwner Signature of Applicant Print N e of Property Owner .��` „"CA'II„ p rty I, /V0 Print Name of Applicant SZP� o;oF NEv�P�g��c',N n11 Z. CANS Notary Public �OlP��1f�e6'0 M: '� = Notary Public c o w o GPr 182a'�` 4O o f N R PUg`G ,'9N• NOS P d 1n ; a0aftfte �o�otl, o SSIONE� ��uuu� ���������� _��, WeS�che6�2�g28:ooi`C This application must he properly comp�ctcJ ut its entirety and must include the notarized sigrits) 3j1�P the legal owner(s)ofthe subject property. and the applicant ofrecord in the spaces provided. AppQ@q;9.E�Q,''°�` 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 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: LC CU, &.� C u T'fL L rL ,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 Master Plumber 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 Sworn to before me this day of 20 day of 20� Signature of Property Owner Signature of pplicant Print Name of Property Owner Print Name of Applicant Notary Public Foiso4973049 e Soto Notary Pu is State of New York 049 estchester County xpires 10/09/20_ZLa This application must he 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. Applications 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 M M W � ■ � O N W O 00 y w ■ °� cn a z o h M v�R. J ■ p`" w � �"� °° C7 z Q E„ rr R .o v LLl fa 0 O O °� ^ ° � 4n " r1 �z ° 3 � c �. y w ° O H W F g � � 3 � • c V� , O a' O Cp a 'o 8 '3 � � _b coz z o .. 0 4 H op o w (� o „ oISO g W 8 V ■ w z �� z w Z V z ' -p ar I—I cn ON W cV) 6 ti v a v` C7 04 z W < ° cQ � TO, � �2 , (� q ? o coGvC � G1 �..� ►-� p., a W00 GN .i .v Q cue •� E"y ■ � Q E M WQ H. " � ov Oz 'Pi \ W u z � a x w A o x w 0 0 ° ' o IS C ou x p v > b N v � cn G4 P-A Ix w ��. o a 1. o 0. Q a f--i U O u O y " x U m � _ 4. " �. a v> > - v c r N Z x w O Q 0Q� � -a� ; ■, z x ° Ca o -C �1I � ° UU w � a � v v c a 041a _ � � n r p �C � ��I BUILI)�V MENT VIL #E 0#RY OOK AUG 2 9 2023 938 KING :1'RY, BR ,NY 10573 (914)9 63 39-5801 VILLAGE OF RYE BROOK K i ' ", r BUILDING DEPARTMENT roo Application for Permit to Remove, Abandon and/or Install Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: 3 Approval Date: AUG 2 23 Permit Fee:$ S4 7 "' Approval Signature: Other: Disapproved: (fees are non-refundable) ******************************************************************************************************* REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Application Completed by Bonded,Licensed Contractor. 2. Your contractor's valid proof of liability insurance.(Village of Rye Brook must be listed as certificate holder) 3.Your contractor's valid proof of workers compensation insurance. (Form#C105.2 or Form#U26.3 /or NY State Workers Compensation Waiver) 4. Fee per Tank: Removal,Abandonment,or Installation: $185.00 per Tank. 5. Dig Safely New York#(dial 811): 6. Inspection by Building Department for removal/abandonment and/or installation. 7. Submit all Manifests&Reports(after work has been completed). 8. Certificate of Compliance will be pro tided when all rz!qu rem nts aw f0ifilled. Application dated, LrJ (I is hereby made to the Building Inspector of the Village of Rye Brook for a permit to remove,abandon,and/or install a Fuel Tank as herein described.The applicant and property owner,by signing this document agree that the subject fuel tank(s)will be removed,abandoned and/or installed in conformance with all applicable Village,County,State& Federal laws,codes,rules and regulations. Indicate Permit Type: Installation Removal( )•Abandonment( )/Above Ground W Buried in Ground ( ) I. Address: �- L AW Q-cw,E SBL: ,le�)91 Zone: 2. Property Owner&Address: LAP,— 1 Z t A-" (Lt -D 6 C D k- Phone#: Cell#: 91J - email: 3. Contractor&Address: 6 c- d�YZa PC) s- I;k- Ot2u 701^, Phone#: c/ `f -Z//r7 ��! Cell#: email: 4. Applicant: s Al, Dd 6a-,- 7-1!� / (7*6e- d>i2o2,#i Z Phone#: q -2-77-A� Cell#: email: 5. Indicate Fuel Type:Fuel Oil( )•L.P.Gas(-Gasoh-ie( )•Other( ): 6. Number and Capacity of each Tank: D U /Z 2-6 C7 7. Exact Location(s)of each Tank: ri — i2�-,1� Mc 2 - S C` - t 6/1/2020 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ENV ezv D 14 Co S T, -U ,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 legal owner of the property to which this application pertains,or that(s)he is the P ��-n. T 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. r� Sworn to before me this 3 Sworn to before me this 10 _— day of _A ,20 day of 20 2;")l /C Signature of Property Owner ature o pplicant Print Name of Property Owner %.�`�� Tint N RD e of Appli ant �\\ *NEOof sr�rF �PS,y , NF ' Notary Public 'o NQua yPUeRC Notary blic _ K\�� a�C est��o� N' = j NOTARY PUBLIC A8�2Jg2g,t),, 'Q `Q.MM HloWd*&.68W H This application must be properly com �dfl<jtpl6trt'ty and must include the notarized s�tgy re( .Soti���` of the legal owners)of the subject property;'Uttd'Me�applicant of record in the spaces provided! EXP1R���\` application not properly completed in its entirety and/or not properly signed shall be deemed null anu void and will be returned to the applicant. z 6/1/2020 CSA 57 wg and 119 wg TANK :!r i , iJll iT'7,'r'i'!� r,.;;r•,ri 1. �� 'A• 4A �Ir I Y7: � �y r •, i r�'ir���:� I'iJ'���f I � t.%�+.',�'dkt �}I ,,• ��� •�4�u�i I�'�Y r f{!(tl't' o�'�!,, � �ry�f,';i,�{I,:'I.�II:�Ia ii,.��I�•.j1 v�'�4Y�i��l �tg ii y.xr o.d R& M: Finished with ArcClad 9'I 'Ar Superior Aboveground Coating I h�h5'�11?B,Tr T'G r p,l 4 iT 'f'6 I1.IT'N•'1� '.•b'•.•y,•1'".n„a'ti��1,r'��^(i�' �ll 1!i Irll r,I �f III I I .114 iyl��d,hlr 11 II II , ,:,I I I�'I',•I'i4';;�1.':.��' r 51..+ r.i ,,•'1,'•h" f�7N :�I I.'I: IIII nl,l Vi I Irl .:II III, I! I, h'i.yn'y::. 1+�• '�` i j' Prr''.t•.,,, Ta Ik �eC,IItM '..r .r,•�•, y I.Ii I 4 III I III I�' �'ii EAr',x '� -.r.�JI x�i ,,r•�'�4'+'�""A'�r`j• �d' a ,mp"h!: I II I I ti! I � !II�III � ' • Taller collar to accommoda a rfet�ed� ,��F: w.glIr ,I I rr I' "I •'I+"•' T^ ,,��{{k III �II{+n,l I II I�I�I I ��I) 'r" x" dlr!"411��'p•1-r 7 1 1 pe` '�y },,.I<;I r ".,1 ri' ' k r�W•p''LJ'll, y iil!II,I I (} (` 4 d f7h Y.r i'*4' �+•� .�rr 't y�,• •N.rl' '"7$ �,,11 ,� �I. I,,'� rl.��I�tol .J bu Ps Ii I� � I'Ih "''III A�..I'�M ,1 �r•j�a '•t ,y� ',d. .�YIIL,�{'.�. 'll:�'iW.:"{"'r'.6.' ;,r}� .,W'.�yi'-M6%.,_• 11r�1'p�i. .: •i,'!'.�.'y .7 ' )d r ! 7fiA���� ti"Id.r4' j '�I �'I' , ilrr' n III'iLf I,I.. ILII II ,� -:•,. is';', ViT !'r,I. d I; 4lrrl I I iid I I j I;I11 II "(' M. f4M;y*p C�+rY fi�1 gahrti } g r7 II i4'i Y r 4 J a: . II ►,� •,d I,] 'r , i;IUper�o! � in� l r .jN"jyll�1 .1+ 'I .,5.. wAy4�11 9G I'II. III ..: .'I,�'}r.dr K' �•7 ,I `�11i ' .,I.�, 1. s� r ;�•rN !,F. ;" .r 'I$'? '' •'r , I ) I �I{t�,'�'M#G '�dl•{' 7 aW bb { rI T.'• .r a III ROT, 173 3150 perrp�t ..1:{ i!.yf.� f v:• 1, jl ,I w{w �p,yI uI , '1 I r % I d •,i�p h14, AT I E y IN 1 ��,`` I ,, I Nlr�i i;Nj !�pl, contalnel S tU IIJe '! `� I' o.rh trans"elloCt'a � .•tMTd�•'•y'►3• F h �. •. 7 IA It .M ,I:.I4 1 qll ''':.I 1. �',' n4,�lAr I•.. " ^C+x,..'^� '... I:} �.!I r I�9 ,iI, r v h� f IPi 1��1�I:I'{li I�yi u�lro�Pye? yr uMIil {1 • 4'4�•Ji ��� r 'I:i�•-.. '},[t� y':'{� 'I n,l�.yl I � x'I"L.Ir'J� '(T !'•. :.'.•..'w:;':4+w:+F.#11 :`�WO Y?h rye"p w1y lI I ,�4, • Heavy , l n "I. p kfF.ti 1-r r+•`,!,1','.;•,, 1i:'iy v y,•.,. '{,.'}}�r;I• 4 `•.7.`BY�71,�,�*�lcp'�i.l'7'�rlllp•v�_�.d�4d'l,'y, �pl I �E.C�vv ��,�ty I..J�ttQ�:Im4Q0 ,� �I ida�N'•, yy,,,,,, L.IL. p M" I t, � � � � ! I ' � ir � �, •..7,` kq,l x!4d, . Fi'",�°''rt•CII'Ikr+h AC 'k'li I I W'6',. l� ` r... •�'I , i y ' '1'.a 1A x II 7 r: Re-cei'tificatlon not reau'ire �� I,r , �,, •. �,d4-"M:K 4 0, ,`f' ' 2' d ,y, I' , l 'r71 I �y, I,y 19 t --•+1' 'I. 1; ! L ,,� ,.•t^^a�'"j,'IY.•!�;'I F,�Y{�„r.'G F'� +cl Gn. I� Ir,A�n 1+11 P„ -X�FI 'Tq 11.7a'y,.l l}�I' h";"�tl ':'I TG'*,, '}!4"4'.;;i.. .:'^fr I'�si•i�: S , " ,J. .7LP .I'Kh;!, h a' .i r 1 .a•II'.f I` .` h �nl I �I''I' errll' I�r. .I dh.ni!+'r' 't 4�.�' �•' I, u nf. H. 1 ;Jt:��• `N� II II �•. I {' D ;r +' . I 1• .,,�. •,.,I,�f!.•.-�'. TI'„ " !{.PI?i 1 4' '�'.;'.F,:�r rw:i;�F�;N � !d. I ''4 � re?V. I MI I ''I�' li I�.I�1.a:! I.4A IIII P I I� .�I�I IL!;I'H, r N�Ola ,"!:. .t1yF,., '•F •I• •• �I.. l.'•�,dl,t+`•'I '1y,r W. '@. { 'k pa•� I ,,14„F, aY, •I I+ I I(� l I I. I Ir il,:.l I �I,I 'I4•• .:: _,:;' '�•'.. ,IJ f.'•:''�'y al:. 'N'.ii��+�^r G'� '-,Q+t•".W'• I h..'I•I Ih O�!. ,�.I}'r Irl1LLIr;�IAdIS, IIL'.I1 11 II I(, ,IIIII I I I��/'; l��!,'rNxIR�.' A'• I��+:'�'��•'r{,ic, 'I .; 'I fr.l' 1N}.rF• •yu:..,,h.. ''? '• '' �; �•Gp', '�M'I,il. IsP•.I.1'� �l 4'II' ;I �; 11 •a';h�+' .. h I ,.. J I I II 11 Pt It' G'`i'r...'"',i-y ^t h�y,Y''� •h .r '4,"I �, I IN I''�, �'y .1,���iy If(,,I],�I�I III I I" (It �w+.;�r,,;�.2t i'• .r. •;�'1,'_I� {r KI� �v:' �+.'�' 7-�, :�•1 �,, �I'�I M ,�I M'l""• 'I Rdl.�`�9I � oi•�• ��•1' �.i,..�,�:7•�•�+*C"'•"Ir•��.',_ 1l 4�w ,7*� 'S ' jryV, ,�• „i yy,,'1 .}•i�r r� ,�' a'Iti:��`I�.t•£•7�:: p l :5.. ry7l d�k F$ a? � '� r meh' i•1'I: 4 , I $J. r I 1�r'I�-Ay � IP �+. r..'r 'k .�•� ..L:;,,. I•',•rp id•� yy� n �dvlsl , , al orrm illsl '1ld di I q?! 1kI _tly `: ,7,4r I'l it Ijh NtiI 11 I prrI t� rp �I i I. el�II'I r•,I Ili'I lllyi i.III' I 1,r tiF' .i ldl d ,IIAIr l • t,.u.J k'.IIaA nld , .,.N..1 I rl7 IIII.11 .!II. flI tad �. t1. r�� .a'•�II�I;'p 't:ld1'i;'' 1 r 1 la. �4 I' II ..I'�*.,,.���.�,� �TIII `?, .G.�,I. I I "1.� •I i. �. I�' :4j'' C{� n ,. :1,,, :.I�'G''!' 1• � 1.a:1',;4 II A'lll itl, .IIII I�,.�1.p,ll IIr I,� IR� I e2 t �N'� �y� $11; 491 tG'. I r,�u�: .•lep)tt�,7r, I r d. .'�'t� - 13.:5 r Zb'11,E I;I a,L,' y4y1 "Ild''I;In,ly y•1t I lu 6,,.IIII;I I', ,r leu I: IN��'I�., ,h'��II''I IhII "hr.dlyy d I 'h'- ""'''EI r.fultl !,., 8�1� ✓y:4. jl'I I!'.'h.^ :fl !''I J, :X 11 !IaII;�.Al�i.a iqL r,� 1!II :1A �J• 1'ILL� 1 '9 II!r I Il i�i l IIIIII :I I,IGitl• II II'r' I'.r,Y .'I1 4 Irl \•I'. 1,r. ,41. .di'd ��1•ry !II .l �I .,:r 9l,.rill„:h I ,I LIT.'I ml�.Idh rdl Il-� .'4 P i f 11(A�. 'I,tr.A. Ip1 111, II r �I Illpl�dl� �I I' q�I,I, .I/.,1'� �,.,I y,,I, I�fPt I.d•. ���I.�:I;�I�I"�.14, :.r .'r•�•.ri.�..�.�. F+I�,'" '1��1]FI'. r`' 'h'•,I.1L!II���I d I-.I.1 M1I. I,I,�I$t I I ril'I�.I I'I,I.,,I� I!y�.,�!'r'.�b I" I;I� !j � �11''.�I tll';0'd IJ,:{•�JI11IF'I d,: II,.�I�,:u al I I,,,I�. ��.,,, :li.�,,+ .I,G,�. .1 r .I� ••r ,�, y+I;.I �•�j�• �• 1.•,I•,ry �OU � �:': ��i' JI};ti'�:IPA;?'• i w'.' , ..L; nY M.Fh '+,'� •.mW.'ti7" r!.rfilFyF:'1I•'.!J'-'`I.iss`�dl�.•.+:',�.:RE��:o-14'1':,i.Qi': ARCO A TANK S ,�,M,, E. Tail GENERAL SPECIFICATIONS 1'-FLOAT Conforms to the latest edition of the ASME code for GAUGE Pressure Vessels, Section VIII, Division 1. Complies 1114•-FILL with NFPA 58. 314"-SERVICE VALVE Rated at 250 psig MAWP from -W! F.to 1259 F. All VALVE o tanks may be evacuated to a full (14.7 psi)vacuum. Vessels are pre-purge with vacuum and conforms with National Propane Gas Association #133-89(a) 1"-RELIEF VALVE Alternative Purge Process. Vessel Finish: Coated with ArcClad;zinc rich FITTINGS LAYOUT epoxy primer and super durable TGIC polyester topcoat. LID 15 9/16"OD COLLAR - LID 9 15 9/16"OD COLLAR x f- Z x tD ZD 30" W M J n x OUTSIDE DIAMETER ' Q 24" v Q a w rOUTSIDE DIAMETER in w O O 18.40" I 24" FOOTRING FOOTRING 24"OD(57 VVG) 30"OD(119 VVG) Est.weight: 268 lbs. Est.weight: 320 lbs. Quantity In Full Load: 208 Quantity in Full Load: 99 Cre: December 14,2018 r 1 For more information 888.558.8265 01 CREED PLASTOCS . TUSING PI--2708 -YELLOW MI IUM DENSITY ' ASYM D2513 and Af ill 831�glehed Oil Crook Plasllcs,Inc.,conform to the requirements of • EI1d NdF9HALaD. MplIMUr�IWAil W1IIeFRPCN1nD� UFdfllNGrlls IPb PIPE 1g " , 3 y .090 0.7 150l500 3 0 _ .OD5 11.6 150 500 1.11 1,315 111.0 .3 10.3 150' OO'60D 14 . .660 11 .15 27.9 IMAM= 141AO 1.660 10.0 666 30,0 130000 1-1 2r INUO 11.0 30.3 60 500 �•' 2p a.3y5 0 2 6 _,_,,,� 59.7 OD 20.,..,LAW 3u 3 00 _ 5 120.0 1a00 0 'A ,,.._ 41144f.9D 1, ,34) 0 0 n .49 386 0 0 40 d" �:� .d 76 O 2WA C'fs MING 18" .625 .090 6.3 . .� 15p 500 1I ._. .. ..._._,.. •..9. .. .. "SOR ND IUM h2"111 G ""NMIMWUL vilf Z tmiow u""IM S" IPB PIPE 2" 2,375 1110 .216 _ _,_b2,Q,_,•_ 100 30D 500 CTS TUBING .625 .090MM 6,3 100 Od 50D " 3 g 2 25.0 00 500 "i onfo� v)(h/ TMb29,9 6�ac��yh�ll air&idB�o�lirtbno91lundupOfh441 yteuomia vvI11�aodo, Ixar1 wra- bjv2 , as a JOINING polya ylon 9a9 1 1 (naY'4®jolnQd ,vllhgr h at 'sip o pehonir;al l pur fillings.Brie Mon- �ppqua e 1� dl t p o, eel fu I n��omp�gto olh�eJ93,for�pro. U'ro for jajpl g Q�J Crook Ia611C9 ra pl a avnllai��tt pan red�u r1.IF�na qhaa�ta'n Iha use gFmedhnni a)typo tl►►ngs'hOr join• -an*e�i0619 rotor to manu olurerfr f trudlogs for proper usorof lhoso pro Oda. s 910N--This toahniclua aan bo do a by handwllh Iha ml )mum use OF tools,It consfala of slmullanuoualy hpo(Inll Iho'e 61nal eurfaae of Iha pipe end Ind Intomol surface of a sockat filling. BU17 FUSION^wllh this 1e4rique,the use fan appikcallon unit must be used.It consists of almullanaously s,,,.�4, ,,rR���ti`aG• '? •� •��� ,,_r A• �' hpoling 1ho equated ands of malobin8 eur{ae ,such an pipe to pipo or pipo to fllHns. ;;�� tip';�!) t ;;••.: tit�••. �` 't•r . SIb1;WALLFU510N�-•�wllhIbistachnlque,Iha sea(npapAl(�allonunitmustb©usacl.Itconalelsofolmullaneouefy l"'�''• `°'� hauling both exlsmol surfaco of Iha pipo an matohing,euriq co of a°auddleN type f111(ne. Re�l�lon 6.1.12 AOHLER. Models: 20RCA(L) Multi-Fuel LPG/Natural Gas 09001 Standard Features L KOHLER. FILE COPY • RDC2 Controller HATKMAEIr RMISTERRo One digital controller manages both the generator set and transfer switch functions (with optional Model RXT). Electronic speed control responds quickly to varying demand. OnCue8 Plus Generator Management System for remote monitoring is included with the generator. • Kohler Command PRO Engine Features Kohler Command PROO OHV engine with hydraulic valve lifters for reliable performance without routine valve adjustment or lengthy break-in requirements. • Designed for Easy Installation The Kohler® Advantage Sturdy aluminum base can be mounted on gravel or a concrete mounting pad. • High Quality Power Fuel and electrical connections through the enclosure wall Kohler home generators provide advanced voltage and eliminate the need for stub-ups through the base. frequency regulation along with ultra-low levels of harmonic - Customer connection terminal block located near the distortion for excellent generator power quality to protect your valuable electronics. controller allows easy access for field wiring. Designed for outdoor installation only. • Premium 5-yr/2000-hr Limited Warranty Included Kohler is known for extraordinary reliability and performance. • Certifications Kohler's premium limited warranty covers parts, labor, and Meets emission regulations for U.S. Environmental travel for the full warranty period. Protection Agency (EPA) with both natural gas and LPG. • Powerful Performance UL 2200/cUL listed. Exclusive Powerboost"' technology provides excellent CSA certified. starting power. § Accepted by the Massachusetts Board of Registration of Plumbers and Gas Fitters. • Aluminum Enclosure Meets 181 mph wind rating. c Attractive aluminum enclosure allows installation as close * Approved for stationary standby applications in locations as 18 inches from your home or small business. ' served by a reliable utility source. c Enclosure panels can be removed without tools to allow easy access for maintenance and service. • Model 20RCAL includes a model RXT automatic transfer • Camouflage Enclosures are available for single-phase units switch. See last page for more details. (optional). Go to KohlerGenerators.com/MossyOak to view • Warranty the available patterns. 5-year/2000 hour limited warranty for on-grid (standby) Mossy oak is a trademark used under license from Haas outdoors,Inc,by Kohler Co applications in locations served by a reliable utility source. Generator Ratings Standby Ratings Line Circuit Natural Gas LPG Breaker Model Alt Voltage Ph Hz kW/kVA Amps kW/kVA Amps Amps Poles 20RCA 2F7 120/240 1 60 18/18 75 20/20 84 100 2 20RCAL 120/208 3 60 17/21 59 17/21 59 70 3 20RCA 2G7 120/240 3 60 17/21 51 17/21 51 60 3 277/480 3 60 17/21 26 17/21 26 30 3 Note: The line circuit breaker is automatically selected based on the generator set model and voltage configuration. RATINGS:Standby ratings apply to installations served by a reliable utility source.All single-phase units are rated at 1.0 power factor.The standby rating is applicable to variable loads with an average load factor of 80%for the duration of the power outage. No overload capacity is specified at this rating. Ratings are in accordance with ISO-3046/1,BS5514,AS2789,and DIN 6271.GENERAL GUIDELINES FOR DERATING:ALTITUDE:Derate 4%per 305 m(1000 ft.)elevation above 153 m(500 ft.).TEMPERATURE:Derate 2%per 5.5°C(100 F)temperature increase above 16°C(60°F). Availability is subject to change without notice.The generator set manufacturer reserves the right to change the design or specifications without notice and without any obligation or liability whatsoever. Contact your local Kohler Co.generator dealer for availability. § Check the appliance manufacturer's specifications for actual power requirements.Consult a Kohlera Power Systems professional to calculate your exact residential power system requirements. Meets NFPA guidelines for 18 inch clearance to combustible materials. Check state and local codes for minimum distance required from a structure. G4-272 (20RCA) 11/22e Alternator Specifications Alternator Specifications Alternator Features Specifications Alternator • Compliance with NEMA, IEEE, and ANSI standards for Manufacturer Kohler temperature rise. Type 2-Pole, Rotating Field . Self-ventilated and dripproof construction. Leads,quantity 2F7 4 • Windings are vacuum-impregnated with epoxy varnish for 2G7 12 dependability and long life. Voltage regulator Digital • Superior voltage waveform and minimum harmonic Insulation: NEMA MG1-1.66 distortion from skewed alternator construction. Material Class H • Digital voltage regulator with t1.0% no-load to full-load Temperature rise 130,C Standby RMS regulation. Bearing:quantity,type 1,Sealed • Rotating-field alternator with static exciter for excellent Coupling Direct load response. Amortisseur windings Full e Total harmonic distortion (THD)from no load to full load with Voltage regulation, no-load to full-load RMS ±1.0% a linear load is less than 5%. One-step load acceptance 100%of Rating Peak motor starting kVA: (35%dip for voltages below) 240 V, 1 ph 2F7(4 lead) 41 (60 Hz) 240 or 480 V,3 ph 2G7(12 lead) 69(60 Hz) Application Data Engine Exhaust Engine Specifications Exhaust System Manufacturer Kohler Exhaust temperature exiting the Engine: model,type CH1000 4-Cycle enclosure at rated kW, dry, 'C(`F) 260(500) Cylinder arrangement V-2 Lubrication Displacement,cm3(cu. in.) 999(61) Lubricating System Bore and stroke, mm(in.) 90 x 78.5(3.54 x 3.1) Compression ratio 8 8:1 Type Full Pressure Main bearings:quantity,type 2, Heavy-Duty Sleeve Oil capacity(with filter), L(qt.) § 1.9(2.0) Bearings Oil filter:quantity,type§ 1,Cartridge Rated RPM 3600 Oil cooler Integral Max.engine power at rated rpm,kW(HP) § Kohler recommends the use of Kohler Genuine oil and filters. LPG 23.0(30.9) Fuel Requirements Natural gas 20.2 (27.1) Fuel System Cylinder head material Aluminum Valve material Steel/Stellite& Fuel types Natural Gas or LPG Fuel supply inlet 1/2 NPT Piston type and material Aluminum Alloy Fuel supply pressure,kPa(in. H2O): Crankshaft material Heat Treated, Ductile Iron Natural gas 0.9-2.7(3.5-11) Governor:type Electronic LP 1 7-2.7(7-11) Frequency regulation, no load to full load Isochronous Frequency regulation,steady state t0.5% Fuel Composition Limits* Nat.Gas LPG Air cleaner type Dry Methane,%by volume(minimum) 90 min. — Ethane,% by volume(maximum) 4.0 max. — Engine Electrical Propane,%by volume 1.0 max. 85 min. Engine Electrical System Propene,%by volume(maximum) 0.1 max. 5.0 max. Ignition system Electronic, C4 and higher,% by volume 0.3 max. 2.5 max. Capacitive Discharge Sulfur, ppm mass (maximum) 25 max. Starter motor rated voltage(DC) 12 Lowe (Btu value, MJ/m (Btu/ft ), (minimum) 33.2 (890) 84.2(2260) Battery(purchased separately): * Contact your local dealer for suitability and rating Berates based on Ground Negative fuel compositions outside these limits. Volts(DC) 12 Battery quantity 1 Recommended cold cranking amps: (CCA) rating for-180C(0°F) 500 Group size 51 G4-272 (20RCA) 11/22e Fuel`Pipe Size Operation Requirements Minimum Gas Pipe Size Recommendation,in.NPT Fuel Consumption,m3/hr.(cfh)@ 60Wz Pipe Length, Natural Gas LPG %Load Natural Gas LPG m(ft.) 281,000 Btu/hr. 340,000 Btu/hr. 100 8.0 (281) 3.9 (136) 8 (25) 1 3/4 75 6.9 (243) 3.1 (109) 15 (50) 1 1 50 4.6 (161) 2.3 (82) 30 (100) 1 1/4 1 25 3.6 (127) 1.7 (59) 46 (150) 1 1/4 1 1/4 Exercise 2.0 (71) 1.0 (35) 61 200 1 1/4 1 1/4 Nominal fuel rating: Natural gas: 37 MJ/m3(1000 Btu/ft.3) ( ) LPG: 93 MJ/m (2500 Btu/ft. ) Generator Set Sound Data LPG conversion factors: .58 3 1 lb. 0 M.535 1 kg Model 20RCA 8 point logarithmic average sound levels are 36.39 ft.3 =1 gal. 66 dB(A) during weekly engine exercise and 70 dB(A) during full-speed generator diagnostics and normal operation.* All sound levels are measured at 7 meters with no load. * Lowest of 8 points measured around the generator. Sound levels at other points around generator may vary depending on installation parameters. RDC2 Controller Features • Programmable exerciser can be set to start automatically on any future day and time,and run every week or every two weeks Voltage: V Freq: eo.0.o H� • Exercise modes: o Unloaded weekly exercise with complete system diagnostics o Unloaded full-speed exercise ID o Loaded full-speed exercise (Model RXT ATS required) Front-access mini USB connector for SiteTech- or USB Utility connection The RDC2 controller provides integrated control for the a Integral Ethernet connector for Kohler®OnCue®Plus generator set, Kohler® Model RXT transfer switch, • Built-in 2.5 amp battery charger programmable interface module (PIM), and load shed kit. • Remote two-wire start/stop capability for optional connection • Membrane keypad: of a Model RDT transfer switch o OFF,AUTO,and RUN pushbuttons • Diagnostic messages: Displays diagnostic messages for the o Select and arrow buttons for access to system engine,generator, Model RXT transfer switch, programmable configuration and adjustment menus interface module (PIM),and load management device. • LED indicators for OFF,AUTO, and RUN modes • Maintenance reminders • LED indicators for utility power and generator set source • System settings: availability and ATS position (Model RXT transfer switch o System voltage,frequency, and phase required) c Voltage adjustment • LCD display: o Measurement system, English or metric o Two lines x 16 characters per line • ATS status (Model RXT ATS required): o Backlit display with adjustable contrast for excellent o Source availability visibility in all lighting conditions o ATS position (normal/utility or emergency/generator) • Scrolling system status display: c Source voltage and frequency o Generator set status • ATS control (Model RXT ATS required): o Voltage and frequency o Source voltage and frequency settings o Engine temperature o Engine start time delay o Oil pressure o Transfer time delays o Battery voltage o Voltage calibration o Engine runtime hours o Fixed pickup and dropout settings • Date and time displays • Programmable Interface Module (PIM) status displays: • Smart engine cooldown senses engine temperature o Input status (active/inactive) • Digital isochronous governor maintains steady-state speed at o Output status (active/inactive) all loads • Load control menus: • Digital voltage regulation: ±1.0% RMS no-load to full-load c Load status • Automatic start with programmed cranking cycle o Test function G4-272 (20RCA) 11/22e ~ KOHLER CO.,Kohler,Wisconsin 53044 USA KOHLER, Phone 9 nearest sales Fax service outlet 646 For the nearest sales and service outlet in the US and Canada,phone 1-800-544-2444 KOHLERPower.com Generator Set Standard Features Literature • Battery cables ❑ General maintenance literature kit • EPA certified fuel system ❑ Overhaul literature kit • Aluminum sound enclosure ❑ Production literature kit • Critical silencer Maintenance • Field-connection terminal block ❑ Maintenance kit(includes air filter, oil, oil filter, and • Fuel solenoid valve and secondary regulator spark plugs) • Line circuit breaker Automatic Transfer Switches and Accessories • Multi-fuel system, LPG/natural gas,field-convertible ❑ Model RDT ATS • Oil drain extension with shutoff valve ❑ Model RXT ATS • OnCues Plus Generator Management System ❑ Model RXT ATS with combined interface/load management board • Premium 5-year/2000 hour limited standby warranty. ❑ Load shed kit for RXT or RDT Covers parts, labor,and travel for the entire warranty period ❑ Power relay modules (use up to 4 relay modules for • RDC2 generator set/ATS controller each load management device) • Rodent-resistant construction ❑ Other Kohler©ATS • Sound-deadening,flame-retardant foam per UL 94, 20RCAL Model Packages class HF-1 ❑ 20RCAL with 100 amp RXT with 16-space load center and Available Options NEMA 1 steel enclosure for indoor installation ❑ 20RCAL with 200 amp service entrance-rated Model RXT Concrete Mounting Pads with combined interface/load management board and ❑ Concrete mounting pad,3 in.thick corrosion-resistant NEMA 3R aluminum enclosure ❑ Concrete mounting pad,4 in.thick Warranty (recommended for storm-prone areas) ❑ 7-Year Limited Warranty Electrical Accessories ❑ 10-Year Limited Warranty ❑ Battery Warranties cover parts,labor,and travel for the entire ❑ Battery heater, 120VAC warranty period. ❑ Battery heater, 240VAC ❑ Cold weather package, 120VAC ❑ Cold weather package, 240VAC ❑ Emergency stop kit Generator Set Dimensions and Weights ❑ PowerSyncs Automatic Paralleling Module(APM) Generator Set Size, L x W x H: 1193 x 660 x 820 mm (single phase only; parallel two 20kW residential generator (47 x 26.0 x 32.3 in.) sets with the RDC2 controller) Shipping Weights: ❑ Programmable interface module(PIM) 20RCA Generator Set: 252 kg(555 lb.) (provides 2 digital inputs and 6 relay outputs) 20RCAL with 100 A RXT ATS w/LC 277 kg (611 lbs.) Enclosure Options 20RCAL with 200 A RXT SE ATS: 272 kg(600 lb.) ❑ Mossy Oak®camouflage enclosure (single-phase only) L Go to KohlerGenerators.com/MossyOak to see these available patterns: Mossy Oak@ Break-Up Country@ Ei Mossy Oak@ Original Bottomland@ H c Mossy Oak@ Shadow Grass@ Habitat- Mossy Oak is a trademark used under license from Haas Outdoors,Inc.,by Kohler Co. Fuel System Accessories !- W ❑ Flexible fuel line (included on QS models) NOTE: Dimensions are provided for reference only and should not be used for planning ❑ Carburetor heater, 120 VAC installation.Contact your local dealer for more detailed Information. ❑ Carburetor heater,240 VAC DISTRIBUTED BY: Carburetor heater is recommended for reliable starting at temperatures below 0°C(32°F). Do not use with cold weather kit. ®2018 Kohler Co. Al rights reserved. G4-272 (20RCA) 11/22e KOHLER. Model: RXT Automatic Transfer Switch 100-400 Amps 9001 Model RXT Automatic Transfer Switch 4 KOHLER. The Model RXT automatic transfer switch is designed for use NATIONALLY REGISTERED fi[E COPY only with Kohler generator sets equipped with the RDC2 generator set/transfer switch controller. The transfer switch operation is controlled by the RDC2 controller. Standard Features • Allows utility voltage display on the RDC2 generator set/transfer switch controller, available exclusively on Kohler, residential and light commercial generator sets • UL listed UL 1008 listed,file#E58962 Models with load centers use UL 67 listed components • CSA certification,file#LR58301, is available for: o Standard ATS without load center (single and three-phase) o Service entrance ATS 100, 200, 300, and 400 amp models • Corrosion-resistant NEMA 3R aluminum enclosure o Padlockable o Approved for indoor or outdoor installation o ANSI 49 gray • NEMA 1 enclosure available on 100 amp load center models • Contactor electrically and mechanically interlocked • Double throw inherently interlocked design • Contactor manually operable for maintenance purposes • Silver alloy main contacts • Transfer switches are 100% equipment rated and can be applied at the rated current without derating (non-service entrance models) • Service entrance models include disconnect circuit breaker on the utility (normal) source side (80% rated) • Five-year limited warranty Standard Interface Board • Standard interface board connects to the Model RDC2 generator set/transfer switch controller. Available Models . Includes a load control contact that provides a 5 minute time • 100, 200, and 400 amp standard and service delay for startup of selected loads after transfer to the entrance models are available. emergency source. Use for large motor loads. • 150 and 300 amp service entrance models are also Combined Interface/Load available. Management Board • Combined interface/load management board is available on single-phase standard and service • Optional combined interface/load management board entrance models. (Not available on 3-phase or load replaces the standard interface board and connects to the center models.) Model RDC2 generator set/transfer switch controller. • 100 amp standard single-phase models are available • The combined board is available on single-phase standard with or without a 16-space load center. Up to 8 and service entrance models. tandem breakers can be used for a total of 24 (Not available on 3-phase or load center models.) circuits. • The combined board automatically manages up to six • 100 amp standard single phase model with a residential loads: 12-space load center and a NEMA 1 enclosure is Up to four customer-supplied power relay modules can available as a standalone non-configurable spec be connected for management of non-essential (GM85273-SA_). secondary loads. • See page 7 for more information. Two HVAC relays are included for control of two independent air conditioner loads. G11-152(Model RXT Automatic Transfer Switch) 4/21 Page 1 Codes and Standards Environmental Specifications Operating temperature - 20oC to 70oC(- 4°F to 158°F) The ATS meets or exceeds the requirements of the following Storage temperature - 40oC to WC(- 40°F to 185°F) specifications: Humidity 5 to 95%noncondensing • Underwriters Laboratories UL 1008, Standard for Automatic Transfer Switches for Use in Emergency Systems,file Contact Ratings #E58962 • Underwriters Laboratories UL 508, Standard for Industrial Engine start 10 A @ 32 VDC Control Equipment SPST normally closed(NC) • CSA certification available,file#LR58301 (not available for Load control 10 A @ 125 VAC 150,300,or 400 amp service entrance or 100 amp load SPST normally open(NO) center models). Must be selected when the transfer switch Auxiliary Position-Indicating Contacts is ordered. • NFPA 70, National Electrical Code Model Number of contacts Contact Rating • NFPA 110, Emergency and Standby Power Systems Normal,Emergency • NEMA Standard IC10-1993,AC Automatic Transfer 100-200A 1,1 Optional 15 A @ 250VAC Switches I Ph 100-200 A 1 1 Optional 15 A @ 250VAC Specifications 1 Ph SE Standard Interface Board 300-400 A 2,2 Standard 10 A @ 480 VAC 1 Ph SE 1,1 Optional Controller interface connections #20 AWG shielded twisted-pair 400 A A and B Belden 9402 or 8762 or equivalent 2,2 Standard Controller interface connections #12-20 AWG 3Ph/3P 1 Ph and 1, 1 Optional 10 A @ 480 VAC PWR and COM (see ATS Installation Manual) Ph Load control contact rating 10 A @ 250 VAC 3 4 P 8 8 Standard 10 A @ 480 VAC Load control connections #12-18 AWG Ph/ Note: For combined interface/load management board specifications, see page 3. Cable Sizes AL/CU UL-Listed Solderless Screw-Type Terminals for External Power Connections Switch Range of Wire Sizes,Cu/AI Size, Emergency and Load Amps Switch Ph, Normal(per phase) (per phase) Neutral Ground Standard 1 (1)#14- 1/0 AWG (1)#14-1/0 AWG (5)#12- 250 KCMIL(Cu)or (5)#10- 250 KCMIL(Al) 12-or 16- space load 1 (1)#14—1/0 AWG (26#14- 1 0 AWG or center Emerg: (1)#14—1/0 AWG ( ) (NEMA 1) (1)#6—2/0 AWG 100 Load:per customer- 16-space (26)#4- 14 AWG or load center 1 (1)#14—1/0 AWG supplied circuit breaker (2)#14- 1/0 AWG or (NEMA 3R) (1)2/0 AWG (9)#6—#14 AWG or Service 1 (1)#12—2/0 AWG (1)#14—1/0 AWG (5)#12- 250 KCMIL(Cu)or (4)#14—1/0 AWG Entrance (5)#10- 250 KCMIL(AI) 3-Phase 3 (1)#14—4/0 AWG (1)#14—4/0 AWG (3)#14—1/0 AWG 150 Service 1 (1)#4-300 KCMIL (1)#6-250 KCMIL (5)#12- 250 KCMIL(Cu)or 200 Entrance (5)#10- 250 KCMIL(Al) Standard 1 (1)#6 AWG—250 KCMIL (1)#6—250 KCMIL (5)#12- 250 KCMIL(Cu)or 200 (5)#10- 250 KCMIL(Al) 3-Phase 3 (1)#14—4/0 AWG (1)#14—4/0 AWG (3)#14—1/0 AWG 300 Service (1)#1 - 600 KCMIL or (2)1/0- 250 KCMIL or (12)1/0- 250 KCMIL or 400 Entrance 1 (2)#1—250 KCMIL (1)#4- 600 KCMIL (6)#4 AWG- 600 KCMIL 1 (1)#4-600 KCMIL or (1)#4-600 KCMIL or (3)#4 AWG—600 KCMIL or (6)#6—3/0 AWG 400 Standard 3 (2)1/0-250 KCMIL (2) 1/0-250 KCMIL (6)1/O AWG—250 KCMIL Note: Data is subject to change. Refer to the transfer switch dimension drawings and wiring diagrams for planning and installation. G11-152 (Model RXT Automatic Transfer Switch) 4/21 Page 2 Optional Combined Interface/Load Management Board The RXT transfer switch is available with either a standard Priority Setting interface board or a combined interface/load management • Loads are added and shed according to their priority. Load 1 board. The combined board allows load management as is the top priority,which is added first and shed last. Load 6 described below. is the lowest priority. • Less critical loads can be turned off automatically when Load Management essential appliances are running. • The combined load management board disconnects • Load priorities are hard-wired at installation. non-critical loads to prevent generator overload, in compliance with NEC. Viewing Load Shed Outputs with OnCue® • The combined load management board monitors generator Plus current and frequency to determine when to add or shed . Use Kohler's OnCue®Plus Generator Management System loads. This monitoring prevents frequency drops that can g y damage valuable electronics like computers and televisions. (sold separately)to view load status(On or Off)for loads • Load management allows the use of a smaller generator set. connected to the load shed relays. • Use OnCues Plus to remotely monitor when loads are shed Operation or added. • Loads are automatically added or shed based on generator • The load shed outputs can be labeled in OnCue®Plus. capacity. Current Transformer • The load control system uses dynamic logic to prevent • The combined load management option includes a ement board shedding important loads unnecessarily when air 9 conditioning, refrigerator, or water pump motors start 400 amp current transfomer(CT)for load monitoring. (patent pending). • A larger diameter CT is available for applications that require • The load management board and generator communicate to larger cables. provide smart power management. The time to shed loads • A 500 amp CT is available for use with a 60RCL generator. decreases as each load is shed to quickly adapt to critical • See the table below for current transformer specifications power requirements. and optional kit numbers. • Load shed power level and frequency setpoints can be adjusted using a personal computer(laptop) and KohlerO SiteTech- software,which is only available to Kohler- authorized distributors and dealers. Load Shed Specifications Connection Rating Connection 125VAC, 10 A total (general purpose) Pilot Relays* 120VAC, 125VA(pilot duty) #12 20 AWG HVAC Relays (qty.2) 125VAC, 10 A(general purpose) #12-20 AWG 120VAC, 125VA(pilot duty) RBUS Communication and Power Use Belden#9402 or equivalent 20 AWG Connections to the RDC2 controller 0.5 A @ 12 VDC shielded,twisted-pair communications cable t * Four(4)pilot relays are provided for customer-supplied normally closed load-switching contactors/relays. The combination of four load relay outputs cannot exceed 10 amps total current draw. Kohler®power relay modules are recommended. t For long distances,use an equivalent shielded,twisted-pair cable for RBUS connections and individual 12-20 AWG wires(qty.2)for power connections. Current Transformer Specifications Ratio Outer Diameter I Inner Diameter ! Service Part (Amps:VAC) mm(in.) mm(in.) Number Sales Kit Part Number CT Availability 400:3 63.5 (2.5) I 28.7(1.13) GM83929 N/A Included with combined board 400:3 111.8(4.4) 57.2(2.25) GM17250 GM17250-KP1-QS Sold Separately 500:3 171.5 (6.75) 108.0 (4.25) GM60264 GM17250-KP2-QS Sold Separately (use with 60RCL) G71-152(Model RXT Automatic Transfer Switch) 4/21 Page 3 Withstand and Close-On Ratings (WCR) Service Entrance Transfer Switch Ratings The service entrance transfer switch is factory-equipped with a normal source disconnect circuit breaker. Suitable for the control of motors, electric discharge lamps,tungsten filament lamps and electric heating equipment where the sum of motor full-load ampere ratings and the ampere ratings of other loads do not exceed the ampere rating of the switch and the tungsten load does not exceed 30 percent of switch rating. Switch Rating,Amps* WCR,RMS Symmetrical Amps at 240 VAC 100,150,200 22,000 300,400 35,000 * Continuous load current not to exceed 80%of switch rating. Contactor Ratings with Coordinated Circuit Breakers Single-phase transfer switches are UL listed at 240 VAC maximum. Three-phase transfer switches are rated at 480 VAC maximum. The following table lists contactor withstand current ratings (WCR) for 100-400 ampere non-service entrance rated switches with specific manufacturer's circuit breakers per UL and Canadian safety standards. Suitable for the control of motors, electric discharge lamps,tungsten filament lamps and electric heating equipment where the sum of motor full-load ampere ratings and the ampere ratings of other loads do not exceed the ampere rating of the switch and the tungsten load does not exceed 30 percent of switch rating. The transfer switch is rated for use on a circuit capable of delivering not more than the RMS symmetrical amperes maximum as shown in the tables below, but no greater than the interrupting capacity of the selected breaker. WCR Ratings with Specific Manufacturer's Molded-Case Circuit Breakers Switch Number WCR,RMS Rating, Voltage, of Poles/ Symmetrical Maximum Amps max. Phases Amps Manufacturer Type or Class Size,Amps 100 240 2 pole/ 10,000 Any Breaker* Any Breaker(0.025 seconds max.) — 1 phase 150,000 HIR 250 125,000 HL 150 100,000 BJ,HJ 125 240 65,000 Square D BG,HG 125 42,000 QG,QJ 125 HID 150 100 3 phase 25,000 BD 125 22,000 GE THED 150 85,000 HL,HR 150 50,000 BJ 126 480 Square D HG,HJ 150 35,000 BG 125 18,000 BD,HD 125 150 240 1 phase 2 pole/ 10,000 Any Breaker* Any Breaker(0.025 seconds max.) — 20 200,000 JR 250 125,000 JL 250 100,000 JJ 250 240 65,000 JG 260 200 3 phase 42,000 Square D QG,QJ 225 25,000 JD 250 85,000 JL,JR 250 480 30,000 JG,JJ 250 18,000 JD 250 * For higher WCR values,contact the factory for additional specific breaker ratings. G11-152 (Model RXT Automatic Transfer Switch) 4121 Page 4 WCR Ratings with Specific Manufacturer's Molded-Case Circuit Breakers Switch Number WCR,RMS Rating, Voltage, of Poles/ Symmetrical Maximum Amps max Phases Amps Manufacturer Type or Class Size,Amps 240 65,000 GE THL04 350 00 400 480 1 phase 42 000 Eaton/Cutler Hammer HMC 800 4 - GE THKM3F 1200 240 65,000 GE THLC4 350 3 pole/ Eaton/Cutler Hammer HMC 800 480 3 phase 42,000 GE THKM3F 1200 THOMV 225 GE SGL1,SGL4,SGL6,SGP1,SGP4,SGP6 600 Eaton/Cutler Hammer LDC,CLDC,HLD,CHILD 600 240 65,000 U,LL,LR 600 Square D QG,QJ 250 Siemens/RE HLD6,HLXD6 600 JGH,JGC,NHH 250 HKD,CHKD,KDC,HKDB,CHKDB,LHH 400 Eaton/Cutler Hammer CHLD,LDC,CLDC,LGH•,LGC•,LGU',LW 600 MDL,CMDL,HMDL,CHMDL,NGS,NGH,NGC,MDLB, 800 CMDLB,HMDLB,CHMDLB NGU 1600 400 - TBC4 400 4 pole/ TBC6,TJL4V,TJL1S-6S,SGL1,SGL4,SGL6,SGP1, 600 3 phase GE SGP4,SGP6,FGN,FGH,FGL,FGP TBC8,TKL4V,TKH8S-12S,TKLSS-12S,SKH8,SKLB, am SKP8,T88 480 50,000 HFD6,HFXD6,HFG,LFG 250 HJDB,HJXD6,SHJD6,HHJD6,HHJXD6,CJD6,SCJD6, 400 HJG,LLG,LJG Siemens/ITE HLD6,HLXD6,SHLD6,HHLD6,HHLXD6,CLD6, 600 SCLD6,HLG LMD6,LMXD6,HLMD6,HLMXD6,MD6,MXD6,HMD6, 800 HMXD6,SMD6,SHMD6,CMD6,SCMD6,HMG,LMG CK400N,CK400NN,CK400H,CK400HH,CJ400L, 400 NSJ400 LC,DJ,DL,LJ,LL,LR,LI,NSJ600 600 I Square D CiK800N,CK600NN,CK800H,CK800HH,MJ 800 CK1000HH 1000 PK,PJ,PL,MH,MasterPact STR 28D,CK1200HH 1200 • With Digitrip 310+LS or LSG Inst.Override set to 12X. G11-152(Model RXT Automatic Transfer Switch) 4/21 Page 5 Dimensions and Weights Note: Always use the transfer switch dimension drawing for planning and installation. Weights and dimensions may vary for different configurations. See the Operation/Installation Manual or your local distributor for dimension drawings. Note: Transfer switch weights and dimensions shown in the table do not include packaging. To estimate the shipping weight,add 3 kg(5 lbs.)or 10%(whichever is larger)to the weight shown. H - W -I � D � Weight t Dimension Amps I Description Dimensions H x W x D mm in. t kg Ob.) Drawing Single phase 623 x 335 x 180 (24.5 x 13.2 x 7.1) 7 (15) ADV-8688 With 12-space load center(NEMA 1) 610 x 330 x 154 (24.0 x 13.0 x 6.0) 12 (26) ADV-9186 With 16-space load center(NEMA 1) 610 x 330 x 154 (24.0 x 13.0 x 6.0) 12 (26) ADV-9187 100 With 16-space load center 614 x 335 x 180 (24.2 x 13.2 x 7.1) 8 (18) ADV-9188 Three phase 3-pole 673 x 462 x 228 (26.5 x 18.2 x 9.0) 15 (33) ADV-9755 Three phase 4-pole 673 x 462 x 228 (26.5 x 18.2 x 9.0) 15 (33) ADV-9755 Service entrance(ASE) 734 x 416 x 175 (28.9 x 16.4 x 6.9) 10 (22) ADV-9046 Service entrance(CSE) 754 x 416 x 175 (29.7 x 16.4 x 6.9) 14 (30) ADV-8797 150 Service entrance(ASE) 734 x 416 x 175 (28.9 x 16.4 x 6.9) 12 (26) ADV-9046 Service entrance(ASE) 734 x 416 x 175 (28.9 x 16.4 x 6.9) 12 (26) ADV-9046 Service entrance(CSE) 754 x 416 x 175 (29.7 x 16.4 x 6.9) 16 (36) ADV-8798 200 Single phase 623 x 335 x 180 (24.5 x 13.2 x 7.1) 7 (15) ADV-8688 Three phase 673 x 462 x 228 (26.5 x 18.2 x 9.0) 15 (33) ADV-9755 300 Service entrance 1452 x 629 x 329 (57.2 x 24.8 x 12.9) 59 (130) ADV-9768 Single phase 1222 x 610 x 343 (48.1 x 24.0 x 13.5) 45 (100) ADV-9756 3-Pole 1222 x 610 x 343 (48.1 x 24.0 x 13.5) 47 (104) ADV-9756 400 4-Pole 1702x 610 x 514 (67.0 x 24.0 x 20.2) 188 (414) ADV-9757 Service entrance 1452 x 629 x 329 (57.2 x 24.8 x 12.9) 59 (130) ADV-9768 t Depth does not include the padlock hasp on the front of the enclosure. t Transfer switch weights are approximate and do not include packaging. Note: Enclosures are type NEMA 3R except as noted. Gt t-152 (Model RXT Automatic Transfer Switch) 4/21 Page 6 Accessories ❑ Auxiliary position-indicating contacts ❑ Status indicator kit for combined interface/load • Standard on 300-400 amp models,optional for others management board • One closed on normal position and one closed on emergency • LEDs indicate normal and emergency source availability position and contactor position • Form C contacts rated 15 A @ 250 VAC • Dual color LEDs for each load indicate load status ❑ Power relay modules (powered or shed) and flash during a test • 50 amp DPST power relay mounted in a NEMA type 3R • Load shed test button allows the operator to cycle the enclosure load shed relays in order of priority(when generator is in RUN mode) • Use up to four modules with the combined interface/load management board • Mounts on the outside of the RXT enclosure • UL/cUL listed • View transfer switch and load status without removing enclosure cover • Dimensions: 172 x 233 x 92 mm(6.8 x 9.2 x 3.6 in.) • An overhang on the enclosure protects the indicator • For more information,see specification sheet G6-143 panel and ribbon cable opening ❑ Status indicator kit for standard interface board • Dimensions: 183 mm x 42 mm (7.20 in.x 1.65 in.) • LEDs indicate normal and emergency source availability • Connects to the combined interface/load management and contactor position board only • Mounts on the outside of the RXT enclosure • Not available for 400 amp/4 pole model • View transfer switch status without removing enclosure • For more information on the status indicator kit,see cover specification sheet G11-123 • An overhang on the enclosure protects the indicator ❑ Auxiliary circuit breaker(service entrance models only) panel and ribbon cable opening • Single-pole type QO circuit breaker • Dimensions: 92 mm x 42 mm (3.62 in.x 1.65 in.) • Mounts on a bracket inside the enclosure • Connects to the standard interface board only • 15 amp and 20 amp circuit breakers are available • Not available for 400 amp/4 pole model • For more information on the status indicator kit, see specification sheet G11-123 Available Models All Model RXT transfer switches are standard-transition 60 Hz automatic transfer switches. Letters in parentheses refer to the model designation code described on the last page. Description Voltages WCR§ Amps Connections 208(C) 240(F) 480(M) Poles Phases RMS Symmetrical Amps Standard(A) • 2(N) 1 10,000 Standard,with 16-space load 0 2(N) 1 10,000 center(B)¶ 100 Standard,with 12-space • 2(N) 1 10,000 load center** Service entrance(ASE,CSE) • 2(N) 1 22,000 Standard,3-phase(A) • • • 3 m or 4(V) 3 10,000 150 Service entrance(ASE) • 2(N) 1 22,000 Standard(A) • 2(N) 1 10,000 200 Service entrance(ASE,CSE) • 2(N) 1 22,000 Standard,3-phase(A) • • • 3 M or 4(V) 3 10,000 300 Service entrance(ASE,CSE) • 2(N) 1 35,000 Standard(A) • 2(N) 1 35,000 400 Service entrance(ASE,CSE) • 2(N) 1 35,000 Standard,3-phase(A) • • • 3(T)or 4(V) 3 42,000 @ 480V 65,000 @ 240 V § Withstand and close-on rating. See pages 3-5 for WCR information and specific breaker ratings. 11 With 16-space load center and NEMA 1 or NEMA 3R enclosure. Up to 8 tandem breakers can be used,for a maximum of 24 circuits. **GM85273-SA_with 12-space load center and NEMA 1 enclosure. Note: Combined interface board is available on single-phase standard or service entrance models. (Not available on 3-phase or load center models.) G71-152(Model RXT Automatic Transfer Switch) 4/21 Page 7 KOHL KOHLER® Phone 9 CO.,Kohler,Wisconsin 9-164 USA Phone 920-457-4441,Fax 920-459-1646 For the nearest sales and service outlet in the US and Canada,phone 1-800-544-2444 KOHLERPower.com Model Designation Model Controls Voltage Poles Enclosure Current Rating Connections Record the transfer switch model designation in the boxes. The transfer switch model designation defines ratings and characteristics as explained below. Sample Model Designation: RXT-JFNC-0200A Model Enclosure RXT. Kohler Automatic Transfer Switch A: NEMA 1 Controls C: NEMA 3R J: Interface for RDC2 Controller * NEMA 1 enclosure is available on 100 amp load center models only. (standard or combined interface/load Current Rating management) 0100: 100 amps 0300:300 amps Voltage/Frequency 0150: 150 amps 0400: 400 amps C: 208 Volts/60 Hz(3-phase only) 0200: 200 amps F: 240 Volts/60 Hz M: 480 Volts/60 Hz(3-phase only) Connections Number of Poles/Wires A: No load center B: With load center(100 amp single-phase only) N: 2-pole,3-wire,solid neutral (120/240 V only) ASE: Service entrance rated T. 3-pole,4-wire,solid neutral CSE: Service entrance rated with CSA certification V: 4-pole, 4-wire,switched neutral (not available for 150 amp models) DISTRIBUTED BY- Availability is subject to change without notice.Kohler Co.reserves the right to change the design or specifications without notice and without any obligation or liability whatsoever. Contact your local Kohler© generator distributor for availability. ®2021 Kohler co.All rights reserved. G11-152 (Model RXT Automatic Transfer Switch) 4/21 Page 8 --------+ .Building Permit Check List&Zoning Anal sis Address: 1 0� SBL Zone: Use: 2� Const.Type: Submittal Date: VRevisiqns Subinittal.Dates: Applicant Nature of Work: 2-0 C_ Reviews:ZBA.AUG 2 9 M3 PB: BOT: Other. NEED � ( FEES:Filing. ��U'� BP: k06 C/O: Flood Plane Legalization ( ) ( ) APP: Dated: Notarized: SBL: Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening ( ) ( ) ENVIRO: Long. Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan Other. ( ) ( ) SURVEY:Dated: Current Archival• Sealed: Unacceptable: ( ) ( ) PLANS:DatePed Sealed: Copies: Electronic Other. (�(� erase �/ Workers Cpomte: Liability �mp.Waiver. Other. ( CODE 753#: 9 0 7 3�C�CJC� �5.3 OCR Dated ( ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit H W.I.C.:_Battery:_Other. (A� PLUMBING:Plans: Permit Nat Gas: LP Gas: N/A/: Other. () ( ) FIRE SUPPRESSION:Plans: Permit N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit N/A Other. ( ) ( ) FUEL TANK:Plans: Permit Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER: Other. ( ) ( ) Other. ( )ARB mtg.date: approval: notes: ( )ZBA mtg. date: approval• notes: ( )PB mtg.date: approval;- notes: REQUIRED EXISITNG PROPOSED NOTES PROVED Arm Circle: F � Front: Front Sides: &r. Main Q Accs.Cov Ft.HS : Sd.H/Sb: T IW : Ft Im Rarki Height/Stories: notes: WestchestsrCotwty Emtsicat Licensing Board Westt Hww County Cossstirrtas Protection tgszca�ra pica se Neck Kalyvas D.O.B: 5/31/1974 Company: NK Electric LLC Po Box 171 Croton-On-Hudson,NY 10620 License No. 1501 Expires on:1213112023 Peter Borducci DATE(MMIDD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE `../ 06/28/2023 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 endorsement(s). PRODUCER NAME: Courtney Potter McCarthy Insurance PHOIAIC.NE.,Fitt. (914)769-0417 FAx 378 Elwood Avenue EMAIL courtne mccarth Insurance.net ADDRESS: y@ Y Hawthorne, NY 10532 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Main Street America Assurance 29939 INSURED INSURERB: NGM Insurance Co. 14788 NK Electric LLC INSURERC: Old Dominion Insurance Co 40231 PO Box 171 INSURER D: Standard Security _ Croton On Hudson, NY 10520-0171 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00005176-5042198 REVISION NUMBER: 4 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 I 7ypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR POLICY NUMBER MMIDD/YYYY MM/DD A Y COMMERCIAL GENERAL LIABILITY Y MPU6337A 11/13/2022 11/13/2023 EACHOCCURRENCE $ 1,000,000 DAMAGE TUArWrEl5__ CLAIMS-MADE u OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 i �GEh,'I_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 00O 000POLICY JECTPRO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 PRO- OTHER: $ B AUTOMOBILE LIABILITY B1U6337A 091ll/2022 09/11/2023 Eaaecd nSINGLELIMIT $ 1. 00,000 ANY AUTO BODILY INJURY(Per person) $ -- OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY X;AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY Per accident r_1 $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ `► WORKERS COMPENSATION AND EMPLOYERS'LIABILITY W1 U6337A 11/16/2022 11/16/2023 X STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? INIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 Nyes,describe under DESCRIPTION OF OPERATIONS below i E.L.DISEASE-POLICY LIMIT $ 100,000 D Disability R70547-000 12/31/2022 12/31/2023 I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder listed as Additional Insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZ� j _ ) x � (CPO) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by CPO on 06/28/2023 at 03:46PM STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured(Use street address lb.Business Telephone Number of Insured only) (914)271-0222 NK Electric LLC le.NYS Unemployment Insurance Employer PO Box 171 Registration Number of Insured Croton On Hudson NY10520-0171 Id.Federal Employer Identification Number of Work Location of Insured (Only required if coverage is Insured specifically limited to certain locations in New York State, or Social Security Number i.e., a Wrap-Up Policy) 26-3224288 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Old Dominion Insurance Co 3b.Policy Number of entity listed in box"la" Village of Rye Brook WIU6337A 3c. Policy effective period 938 King Street 11/16/2022 11/16/2023 Rye Brook, NY 10573 3d. The Proprietor,Partners or Executive Officers are 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 "T' 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 Certificate of Insurance to the entity listed above as the certificate holder in box"T'. The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment ofpremiums or within 30 days IF there are reasons other than nonpayment ofpremiums 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"3cr; whichever is earlier. Please Note:Upon the 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, I 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: William McCarthy (Print name of authorized representative or licensed agent of insurance carrier) Approved by: June 28,2023 (Signature) (Date) Title: AGENT Telephone Number of authorized representative or licensed agent of insurance carrier: 914-769-0417 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 (9-07) 0 :0.10;0;91019:0;0;0:0;9:0:0:0;o:*;Q:O:o:*;.:O:.:*:.:0:0;010;.;.;Q;.;O:o:.:.;Q;.:.;.;.;.;%;.:I WAM ,munvoi-1.11 10 .0 4 0 0 3, a C0 Y, 1, "d A Ro 0 C\j C14 Ad 4-4 A, o i.0 .0 .0 N U,,�ajvo o P, Mill; A 0 0, ..... .....I 21 v pmo al� m 00 In V) L—w, �4 z CD 0 U) T— 1 11 11 .2 .1 11 uj ctionz 0 .0, A Z z 0 LL C<L U, 00 L<L 0 C\1 0 0 0! 4-4 LC) 7b; g, 0 U.N ..W1, A e au 'T'. cj� I- 1� IN 4-4 C) 4.4 d V F L F)j)RM, RRv- !0, 0 0 V AR, (Y) R Au v N)"U", 00 V \T,4-� 03 Ism Fit, tD Py, 0 0 o:o:o:o:o:o:o:o:D:0:0*,0;0:0:0:0:0:0'.0:4:0:0:0:0:0:0!0:0:0:0:0:0:*:o;o;o:o:o:o:o:o:o:o:o:o:o:o:o:o�o;o:o:o:o:o:o;*:o:o;o:.:�;v M AA, mg. jig WWW", ^ HERIPRO-02 CWAZOLEK 7 DATE(MM/DCIYYYY) CERTIFICATE OF LIABILITY INSURANCE 2/2812023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS ORDED BYTHEPOLICIZS BE CERTIFICTE CERTIFICATE FOFn INSURANCE DOES NATIVELY OR IOT CONVELY STITUTE XAECONTTR CTND OR TBETWEENER THE OTHE ISSUING VERAGE FNSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. _ IMPORTANT: If the certificate holder is an ADDITIONAL INSUREC,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). C ACT T PRODUCER E,---- PHONE FAX Emery 8 Webb,Inc. A/c,No Ezt):(845)896-6727 Alc,No:(845)896-6877 989 Main Street AI Fishkill,NY 12524 INSURERS AFFORDING COVERAGE NAIC# _ INSURER A:Utica National Of TX 43478 INSURED INSURER B:Graphics Arts Mutual 25984 Heritage Propane,Inc. INSURER C:Utica National Insurance of Ohio 13998 PO Box 512 INSURER D Croton Falls,NY 10519-0512 INsURERE: _ — INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONDI1ION 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP UMITS TYPE OF INSURANCE 1,000 000 TAUTOMOBILE CIAL GENERAL LIABILITY EACH OCCURRENCE S 3/512023 3/5/2024 DAMAGE TO RENTED 100,000 IMS-MADE ❑X OCCUR X CPP 4407367 5,000 MED EXP An one rson PERSONAL 8 ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 EGATE LIMIT APPLIES PER: 2,000,000 ❑jpa- LDC PRODUCTS-COMP/OP AGG COMBINED SINGLE LIMIT 1,000,000 LIABILTY TO 6058513/5/2023 3/5/2024 BODILY INJURY Per arson X SCHEDULED BODILY INJURY Per ecGdent $ RE�ONLY AUpTNOpSW�1 p PROPERTY AMAGE X AUTOS ONLY X AUTOS tH Per acc dent $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 21000,1000 EXCESS LIAB CLAIMS-MADE CULP5035798 3/612023 3/5/2024 AGGREGATE 2,000,000 DED X RETENTIONS 10,000 PER OTH- WORKERS COMPENSATION STATUTE AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A �FFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE illandatory n I1 yes,describe under E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 131,Additional Remarks Schedule,may be attached if more space Is required) Certificate Holder is listed as Additional Insured with regard to General Liability coverage,as required by written contract or permit,subject to the language of the policy. CERTIFICATE HOLDER ___ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCOHCANCE JYITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Village of Rye Brook � 938 King Street iRye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and Icgo are registered marks of ACORD NYSI F New York state Insurance Fund PO Box 66699,Alban' , NY 12206 ysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) 0 ■ ^^^^^ 205614472 HERITAGE PROPANE INC PO BOX 512 0 CROTON FALLS NY 10519 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER HERITAGE PROPANE INC VILLAGE OF RYE BROOK PO BOX 512 938 KING STREET CROTON FALLS NY 10519 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER T POLICY PERIOD C ATE W1485 352-7 494725 ! 07/20/2023 TO 07/20/2024 T/7/15 2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE IN 3URANCE FUND UNDER POLICY NO. 1485 352-7, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECTI TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY;INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:/M/WW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION!ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. II NEW YORK STAT SUP NCE FUND DIRECTOR,INSURANCE FUND UND RWRITING VALIDATION NUMBER: 920889018 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Saturday, September 9, 2023 11:43 AM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 09/09/2023 11:42 To: VIL RYE BROOK PRIMARY Transmitted- 09/09/2023 11:42 00001 Ticket: 09093-000-153-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 12 To: Name: LAWRIDGE DR Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: LEFT SIDE OF PROPERTY AS FACING NearSt: SLEEPY HOLLOW RD Means of Excavation: HAND TOOLS Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: U Work Type: INSTALL CONDUIT Estimated Work Complete Date: 09/25/2023 Depth of excavation: 2 FEET Site dimensions: Start Date and Time: 09/18/2023 07:00 Must Start By: 10/02/2023 ------------------------------------------------------------------------------ Contact Name: NICK KALYVAS Company: NK ELECTRIC Addrl: 2055 ALABANY POST RD Addr2: City: CROTON ON HUDSON State: NY Zip: 10520 Phone: 914-882-8515 Fax: Email: nick@nk-electric.com Field Contact: NICK KALYVAS Alt Phone: 914-882-8515 Email: nick@nk-electric.com Working for: VILLAGE OF RYE BROOK ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED SUEZ WTR WESTCHESTER VIL RYE BROOK WESTCHESTER CTY SWR 1 r �"3 Y • WIN �. fit IT a Cal 30 tv m t CA (A) '�'ibk 1N3W1N a N l 8 P/V/ 7-7 NOMI8 3A :1 39VIIIn CZOZ 6 z gnd G64 `