Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Abandoned Application
Building Permit Check List&Zoning Analysis Address: I Cz c'a SBL 3.5�i Lt 3 — - S, 2 Zone:'2-LS Use: Z Const.Type: Other. Submittal Date: 't 1-3 Z Revisions Submittal Dates: Applicant Nature of Work: _3� 6—yw U AT'0 6 BIRNAZE-C�ft_ Reviews:ZBA: J U L 1 3 2021 PB: BOT: Other. NEED OK ( ) ( ) FEES:Filing. _!�_, BP: 33n �r,7 C/O: Legalization: O O APP: Dated: —Notarized ✓ SBL --truss Truss I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening. ( ) ( ) NVIRO:Long. Short Fees: N/A: ( ) ( SITE PLAN:Topo: Site Protection: S/W Mgmt.: Tree Plan. Other. ( ) ( ) SURVEY:Dated Current Archival• Sealed Unacceptable: ( ) ( ) PLANS:Date Stamped Sealed Copies: Electronic: Other. ( ) ( ) License: Workers Comp: Liability: Comp.Waiver. Other. ( ) ( ) CODE 753#: Dated N/A: ( ) (� 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. 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. O O 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 EXISTING PROPOSED NOTES Arm: F : _ Fro�ee: — Front Front _ Sides: Main C v — Accs.Cov — Ft.HS : — S . S Tot Imp Ft.Imp: P Height/Stories: notes `J rK y SE LZ Loc„�Q i i> �/ rQ .C y �y kT S Residential Building Permit Fee Work Sheet Permit#: Date Issued: SBL: Zone: Address: Property Owner& Contact Info: Job Description: For all new dwellings and for additions measuring 800 sq. ft. or more made to existing dwellings, the following fee schedule shall apply: (plus any alteration fees) Total Sq. Ft. (excluding basements)x $225.00 x $I5.00/$I,000.00 Basement Sq. Ft. x $65.00 x $I5.00/$I,000.00 -------------------------------------------------------------------------------------------------------------------- New Constnuction Sq,.Ft. • New Construction Cost • Building Permit Fee Basement= sq.ft.x$65.00 = $ x$I5.00/$I,000.00 = $ Attached Garage= sq.ft.x $225.00= $ x$I5.00/$I,000.00 = $ I,Fl. = sq. ft.x$225.00= $ x$I5.00/$I,000.00= $ 2"'Fl. = sq. ft.x$225.00 =$ x$I5.00/$I,000.00= $ 3`1 Fl. = sq. ft.x$225.00= $ x$I5.00/$I,000.00= $ 41,Fl. = sq. ft.x$225.00= $ x$I5.00/$I,000.00= $ Total Sq.Ft. = sq. ft. Total Cost= $ Total B.P.Fee= $ Total Amount Paid = $ Total Amount Due= $ Date: Signed: y I�CW.Wyj r VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Paul S.Rosenberg (914)939-0668 Fax(914)939-5801 Christopher J.Bradbury na wy.aebrook.orQ TRUSTEES BUILDING&FIRE Susan R.Epstein INSPECTOR Stephanie J.Fischer Michael J.Izzo David\I.Heiser Jason A.Klein NOTICE OF DISAPPROVAL Application # 21-029 July 19, 2021 Lloyd Mallah&Mamie Nlallah 17 Birch Lane Rve Brook,New York 10573 PLEASE TAKE NOTICE that your application for building permit dated,Jule 13, 2021, for the premises located at 17 Birch Lane, Parcel ID# 135.43-1-5.25, has been disapproved because of non-compliance with the following section(s) of the Code of the Village of Rve Brook: 5250-4.1.B.(3) To the extent practicable, generators shall be collocated with other existing or proposed mechanical equipment, such as an air conditioning unit... The applicant proposes to install the generator on the opposite side of the house from the air conditioning units. Please revise your plans to full)-comply with the applicable section(s)of Village Code,or an appeal to this decision may be brought before the Village Zoning Board of Appeals (Z.BA) in accordance with §250-13 and §250-40 of the Code of the Village of Rye Brook. Applications to appear before the ZBA are available at the Building Department or online at www.Lyebrook.org. Sincerely, Michael J. Izzo Building&Hire Inspector mizzo laebrook.org BUILDING DEPARTMENT D CEN7 DD VILLAGE OF RYE BROOK R JUL 13 2021 938 KING STREET RYE BROOK,NY 105 (914)939-0668 FAX(914)939-5801 1 VILLAGE OF RYE BROOK n2n &_ i_�.> ,g BUILDING DEPARTMENT *********************************************************************************************************** FOR OFFICE USE ONLY: Approval Date: Permit# Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: : Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: i Application Fee: -O. ? Permit Fees: *********************************************************************************************************** APPLICATION TO INSTALL A PERMANENT STANDBY BACKUP GENERATOR Application dated: 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§2504.1.of the Code of the V illage of Rye Brook,as per detailed statement described below.Please note that electrical and plumbing permit applications must be filed separately by those licensed professionals,and that separate permits are required for the installation of any related fuel tanks.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. l. Job Address: 2. Parcel ID#: Zone: 3. N.Y.State Construction Classification: N.Y.State Use Classification: T 4. Proposed Generator&Fuel Type(Describe in detail): �► �t� 5. Property Owner: kL Address: Phone# qj7 /7202j 7c:W aCell# I) email: L �'oY�l✓� �670� IL(Ot1�`C0� Applicant: ©(� Address: ! r!O Phone# - 6 Cell# email: Architect or Engineer(if applicable): A) A Address: Phone# Cell# email: General Contractor: / / // Address: oL r Il9l� M f1t Phone# ���- - g��q_Cell# email: t 3l21119 m %3 r k - 1 T ' d AT + L i 6. Give exact dimensions from proposed generator to lot lines: front yard: rear yard: r right side yard: 0 left side yard: 10 7. If building is located on a corner lot,which street does it front on: POT' 0oefuE2- 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: l� 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: V (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: V (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:_J/(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: 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: V--"(a tree replanting schedule may be required) 14. Does the proposed projectinvolve a Home-Occupation as per Chapter 250-38 of the Code of the Village of Rye Brook? Yes: No: V If so,indicate: TIER I: TIER IL II: TIER III: 15. What is the total estimated cost of construction: S ga,D- lJ (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: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: �b h D. (fro✓A S ,being duly sworn,deposes and states that he/she is the applicant above named, (print n me of individual signing as the applicant) an further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the AULO TU 915CW - &AP- for the legal owner and is duly authorized to make and file this application. (indicate architect,wntractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention &Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this �1 Sworn to before me this t7 4'`_ day of J�.( k�Q_ , 20 day Sri h Q , 20 9 l ma Sign re of Prope6 caner CAROL ANN PRIORE Si ature of Applicant Notary Public (� Connecticut I d I t l G` IQ My Commission Expires May 31,2025 TO C eA Print Name of Property O er Print Name of Applicant `•U V Notary Public Notary Public �t d a co (o(0 7 if 9 This application must be properly completed in its entirety and must include the notarized signature(s)of the legal owner(s)of the subject property,and the applicant of record in the spaces provided.Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void,and will be returned to the applicant. Please note that application fees are non-refundable. 2 3/21/19 E 0 -0 L ay (n L a) O U C f0 (n *;_- L 0 O •X c -o � a U) C O (B L 0 E Q -0 a) O N ,O 0 C � (� O E � -0 N `� O 1 C L U +' � N O O O U 00 Y 0- O -0 L O i M O C - U) O O O N 5O 5, -0 T Q' C) O U 0 C N V p� L 4- M (� N CO C O (u X N Lo U m N E O -0 O) E L E o � C L Q N >+ m X Q Q Q � + p a��� °�• pp f Ph � / -- IR � � o 4 k R': nP , fry Model: 30RCL KOHLER. Power Systems Multi-Fuel Natural Gas/LPG 0 FAR 9001 Standard Features gl'STEn�s • Kohler Co. provides one-source responsibility for the � NATIONALLY 4EGiSTERED generating system and accessories. • The generator set and its components are prototype-tested, factory-built, and production-tested. • The generator set accepts rated load in one step. • A standard five-year or 2000 hour limited warranty covers all systems and components. • Quick-ship (QS) models with selected features are available. See your Kohler distributor for details. • RDC2 Controller o One digital controller manages both the generator set and transfer switch functions (with optional Model RXT transfer switch). _- o Designed for today's most sophisticated electronics. o Electronic speed control responds quickly to varying household demand. o Digital voltage regulation protects your valuable electronics from harmonic distortion and unstable power The Kohler® Advantage quality. • High Quality Power Two-line, backlit LCD screen is easy to read in all lighting Kohler home generators provide advanced voltage and conditions, including direct sunlight and low light. frequency regulation along with ultra-low levels of • Engine Features harmonic distortion for excellent generator power quality to o Powerful and reliable 2.2 L turbocharged liquid-cooled protect your valuable electronics. engine o Electronic engine management system. • Extraordinary Reliability o Simple field conversion between natural gas and LPG Kohler is known for extraordinary reliability and fuels while maintaining emission certification. performance and backs that up with a premium five-year or . Innovative Cooling System 2000 hour limited warranty. Electronically controlled fan speeds minimize generator • All-Aluminum Sound Enclosure set sound signature. • Certifications • Quiet Operation The 60 Hz generator set engine is certified by the Kohler home generators provide quiet, neighborhood- Environmental Protection Agency (EPA)to conform to the friendly performance. New Source Performance Standard (NSPS)for stationary spark-ignited emissions. UL 2200/cUL listing is available (60 Hz only). CSA certification is available (60 Hz only). Accepted by the Massachusetts Board of Registration of Plumbers and Gas Fitters. • Approved for stationary standby applications in locations Generator Set Ratings served by a reliable utility source. Standby Ratings Natural Gas LPG Altemator Voltage Ph Hz kW/kVA Amps kW/kVA Amps 4E5.6 120/240 1 60 30/30 125 30/30 125 120/208 3 60 30/37 104 30/37 104 127/220 3 60 30/37 98 30/37 98 120/240 3 60 30/37 90 30/37 90 4D8.3 277/480 3 60 30/37 45 30/37 45 220/380" 3 50 25/31 47 25/31 47 230/400 3 50 25/31 45 25/31 45 240/416* 3 50 25/31 43 25/31 43 * 50 Hz models are factory-connected as 230/400 volts.Field-adjustable to 220/380 or 240/416 volts by an authorized service technician. RATINGS.All three-phase units are rated at 0.8 power factor.All single-phase units are rated at 1 0 power factor.Due to manufacturing variations.the ratings tolerance is±5%. Standby RaMgs:Standby ratings apply to installations served by a reliable utility source.The standby rating is applicable to varying loads with an average load factor of 80%for the duration of a power outage.No overload capacity is specified for this rating.Ratings are in accordance with ISO-3046/1,BS 5514,AS 2789,and DIN 6271.GENERAL GUIDELINES FOR DEFLATING.AIUWe.Derate 1.3%per 100 m(32811)elevation above 200 m(656 ft.) Temperature:Derate 3.0%per 10'C(18"F)temperature above 25°C(77'F).Availability is subject to change without notice The generator set manufacturer reserves the night to change the design or specifications without notice and without any obligation or liability whatsoever.Contact your local Kohler generator distributor for availability. G4-229 (30RCL) 4/16 Alternator Specifications Specifications Alternator • NEMA MG1, IEEE, and ANSI standards compliance for Manufacturer Kohler temperature rise and motor starting. Exciter type Brushless,Wound-Field • Sustained short-circuit current of up to 300%of the rated Leads:quantity,type current for up to 10 seconds. 4E5.6 4, 120/240 4D8.3 12, Reconnectable • Sustained short-circuit current enabling downstream circuit Voltage regulator Solid State,volts/Hz breakers to trip without collapsing the alternator field. Insulation: • Self-ventilated and drip-proof construction. Material Class H Temperature rise 130`C,Standby • Windings are vacuum-impregnated with epoxy varnish for Bearing:quantity,type 1,Sealed dependability and long life. Coupling Flexible Disc Amortisseur windings Full • Superior voltage waveform from a two-thirds pitch stator and Voltage regulation,no-load to full-load -1.0%Maximum skewed rotor. Unbalanced load capability 100%of Rated Standby • Total harmonic distortion (THID)from no load to full load with Current 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 4E5.6(4 lead) 44 (60 Hz) 480 V,400 V 4D8.3(12 lead) 120(60 Hz) 88(50 Hz) Application Data Engine Exhaust Engine Specifications 60 Hz 50 Hz Exhaust System 60 Hz 50 Hz Manufacturer Kohler Exhaust manifold type Dry Engine:model,type Residential Powertrain Exhaust temperature at rated kW,dry KG2204T,2.2 L,4-Cycle exhaust, C( F) 633(1171) Turbocharged Maximum allowable back pressure. Cylinder arrangement In-line 4 kPa(in.Hg) 7.5(2.2) Displacement,L(cu.in.) 2.2(134.25) Bore and stroke.mm (in.) 91 x 86(3.5 x 3.4) Fuel Compression ratio 10.5:1 Piston speed,m/min.(ft./min.) 310(1016) 258(847) Fuel System Main bearings:quantity,type 5,plain alloy steel Fuel type Natural Gas or LPG Rated rpm 1800 1500 Fuel supply line inlet 1 in.NPT Max.power at rated rpm,kW(HP) Natural gas fuel supply pressure,kPa LPG 47.8(64.1) NA (in.H2O) 1.24-2.74(5-11) Natural Gas 47.6(63.9) NA LPG vapor withdrawal fuel supply Cylinder head material Cast Iron pressure,kPa(in.H2O) 1.24-2.74(5-11) Piston type and material High Silicon Aluminum Fuel Composition Limits* Nat.Gas LP Gas Crankshaft material Nodular Iron Methane,%by volume 90 min. Valve(exhaust) material Forged Steel Ethane,%by volume 4.0 max. — Governor type Electronic Propane,%by volume 1.0 max. 85 min. Frequency regulation,no-load to Propene,%by volume 0.1 max. 5.0 max. full-load Isochronous C4 and higher,%by volume 0.3 max. 2.5 max. Frequency regulation,steady state -1.0% Sulfur,ppm mass 25 max. Frequency Fixed Lower heating value, Air cleaner type Dry MJ/m3(Btu/f 3),min. 33.2(890) 84.2(2260) Engine Electrical Fuels with other compositions may be acceptable. If your fuel is outside the listed specifications,contact your local distributor for Engine Electrical System further analysis and advice. Ignition system Electronic Battery charging alternator: Lubrication Ground(negative/positive) Negative Lubricating System Volts(DC) 14 Type Full Pressure Ampere rating 90 Oil pan capacity,L(qt.) 4.2(4.4) Starter motor rated voltage(DC) 12 Oil added during oil change(on average). Battery,recommended rating for-18°C(0°F): L(qt.) 3.3(3.5) City.,cold cranking amps(CCA) One,630 Oil filter:quantity,type 1,Cartridge Battery voltage(DC) 12 Oil cooler Remote Battery group size 24 G4-229 (30RCL) 4/16 Application Data Cooling RDC2 Controller Radiator System 60 Hz 50 Hz 13) Enginent waters pa(IF) 45 (0.7 a Engine jacket water capacity,L(gal.) 2.65(0.7) Radiator system capacity,including vwep: 24ov engine,L(gal.) 13.2(3.5) Freq: 80.0 Hz Water pump type Centrifugal o o Fan diameter,mm(in.) qty.3 @ 406(16) Q ro Fan power requirements(powered by ® aA engine battery charging alternator) 12VDC,18 amps each Operation Requirements Air Requirements 60 Hz 50 Hz The RDC2 controller provides integrated control for the Radiator-cooled cooling air, generator set, Kohler®Model RXT transfer switch, m3/min.(scfm)= 51 (1800) 51 (1800) programmable interface module(PIM), and load management. Combustion air,m3/min.(cfm) 1.6(57) 1.3(45) Air over engine,m3/min.(cfm) 25(900) 25(900) The RDC2 controller's 2-line LCD screen displays status # Air density=1.20 kg/m3(0.075 Ibm/ft3) messages and system settings that are clear and easy to read, Fuel Consumption-` even in direct sunlight or low light. Natural Gas,m3/hr.(cfh)at%load 60 Hz 50 Hz RDC2 Controller Features 100% 12.0 (424) 10.0 (353) a Membrane keypad 50% 7.6 (268) 6.2 (289) o OFF,AUTO,and RUN push buttons 50/0 7.6 (268) 6.3 (222) p 25% 5.5 (196) 4.5 (159) o Select and arrow buttons for access to system Exercise 3.4 (121) 2.8 (99) configuration and adjustment menus LP Gas,m3/hr.(cfh)at%load 60 Hz 50 Hz • LED indicators for OFF,AUTO,and RUN modes 100% 4.7 (166) 3.9 (138) • LED indicators for utility power and generator set source 75% 3.7 (132) 3.0 (105) availability and ATS position (Model RXT transfer switch 50% 2.8 (100) 2.3 (81) required) 25% 1.9 (69) 1.6 (56) • LCD screen Exercise 1.2 (41) 1.0 (35) o Two lines x 16 characters per line $ Nominal Fuel Rating: Natural gas,37 MJ/3m3(1000 Btu/ft3) o Backlit display with adjustable contrast for excellent LP Vapor,93 MJ/m (2500 Btu/ft3) visibility in all lighting conditions LP vapor conversion factors: • Scrolling system status display 8.58 ft.3=1 lb. 9 Y P Y 0.535 m3=1 kg. o Generator set status 36.39 ft.3=1 gal. o Voltage and frequency o Engine temperature Sound Enclosure Features c Oil pressure • Sound-attenuating enclosure uses acoustic insulation that c Battery voltage meets UL 94 HF1 flammability classification and repels o Engine runtime hours moisture absorption. • Date and time displays • Internally mounted critical silencer. • Smart engine cooldown senses engine temperature • Skid-mounted,aluminum construction with two removable a Digital isochronous governor to maintain steady-state speed access panels. at all loads • Fade-, scratch-,and corrosion-resistant KohlerO cashmere • Digital voltage regulation: ±1.0%RMS no-load to full-load powder-baked finish. • Automatic start with programmed cranking cycle Sound Data • Programmable exerciser can be set to start automatically on any future day and time, and to run every week or every two Model 30RCL 8 point logarithmic average sound levels are weeks 54 dB(A) during weekly engine exercise and 61 dB(A) during • Exercise modes full-speed generator diagnostics and normal operation. For o Unloaded exercise with complete system diagnostics comparison to competitor ratings,the lowest point sound levels o Unloaded full-speed exercise are 52 dB(A)and 60 dB(A) respectively.* o Loaded full-speed exercise(Model RXT ATS required) All sound levels are measured at 7 meters with no load. a Front-access mini USB connector for SiteTech- connection * Lowest of 8 points measured around the generator.Sound levels at other points • Integral Ethernet connector for Kohler®OnCue®Plus around generator may vary depending on installation parameters. g • Built-in 2.5 amp battery charger • Remote two-wire start/stop capability for optional connection of a Model RDT transfer switch See additional controller features on the next page. G4-229 (30Rcu 4/16 KO`,iLER CO.,Kohler,Wisconsin 53044 USA Kohler Power Systems Phone 920-457-4441,Fax 920-459-1646 Asia Pacific Headquarters For the nearest sales and service outlet in the 7 Jurong Pier Road US and Canada,phone 1-800-544-2444 Singapore 619159 KOHLERPower.com Phone(65)6264-6422,Fax(65)6264-6455 Additional RDC2 Controller Features Available Options, Continued • Diagnostic messages Starting Aids§ Displays diagnostic messages for the engine, generator, j Block Heater, 120 V. 1 Ph Model RXT transfer switch, programmable interface ❑ Block Heater,240 V, 1 Ph module (PIM), and load management device ❑ Oil Pan Heater, 120 V. 1 Ph Over 70 diagnostic messages can be displayed ❑ oil Pan Heater,240 V, 1 Ph • Maintenance reminders § One block heater or oil pan heater is recommended for ambient • System settings temperatures below 0°C(32°F). At temperatures below-18°C(0°F), System voltage,frequency, and phase installation of both heaters is recommended. Voltage adjustment Automatic Transfer Switches and Accessories Measurement system, English or metric ❑ Model RDT Automatic Transfer Switch • ATS status (Model RXT ATS required) ❑ Model RXT Automatic Transfer Switch Source availability ❑ Model RXT Automatic Transfer Switch with Combined ATS position (normal/utility or emergency/generator) Interface/Load Management Board Source voltage and frequency i Load Shed Kit for RDT or RXT • ATS control (Model RXT ATS required) ❑ Power Relay Modules(use up to 4 relay modules for each Source voltage and frequency settings load management device) Engine start time delay Miscellaneous Transfer time delays ❑ Rated Power Factor Testing Fixed pickup and dropout settings Literature Voltage Calibration J General Maintenance Literature Kit • Programmable interface module (PIM)status displays I Overhaul Literature Kit Input status (active/inactive) ❑ Production Literature Kit Output status(active/inactive) warranty • Load control menus J Extended 5-Year/2000 Hour Comprehensive Limited Warranty Load status Other Options Test function Generator Set Standard Features J • Aluminum sound enclosure with enclosed silencer • Battery rack and cables Dimensions and Weights • Electronic, isochronous governor Overall Size,L x W x H,mm (in.): 1880 x 836 x 1169 • Flexible fuel line (74 x 32.9 x 46.0) • Gas fuel system (includes fuel mixer, electronic secondary Shipping Weight,wet,kg(Ib.): 599(1320) gas regulator,two gas solenoid valves, and flexible fuel line Weight includes generator set with engine fluids, sound enclosure, between the engine and the skid-mounted fuel system silencer,and packaging. components) • Integral vibration isolation • Line circuit breaker • Oil drain extension • OnCue�,'Plus Generator Management System H • Operation and installation literature • RDC2 controller with built-in battery charger • Standard five-year or 2000 hour limited warranty Available Options Approvals and Listings NOTE:This drawing is provided for reference only and should not be used for planning installation.Contact your local distributor for more i UL 2200/cUL Listing(60 Hz only) detailed information. ❑ CSA Approval(60 Hz only) DISTRIBUTED BY: Controller Accessories Programmable Interface Module(PIM) (provides 2 digital inputs and 6 relay outputs) Electrical System ❑ Battery Battery Heater 2016 by Kohler Co.All rights reserved. G4-229 (30RCL) 4/16 Model: 30RCL KOHLER. Power Systems Multi-Fuel Natural Gas/LPG 09001 Standard Features 14�g • Kohler Co. provides one-source responsibility for the NATIONALLY RFG611`PPD generating system and accessories. • The generator set and its components are prototype-tested, factory-built,and production-tested. r • The generator set accepts rated load in one step. Is A standard five-year or 2000 hour limited warranty covers all systems and components. • Quick-ship (OS) models with selected features are available. See your Kohler distributor for details. • RDC2 Controller o One digital controller manages both the generator set and transfer switch functions (with optional Model RXT transfer switch). o Designed for today's most sophisticated electronics. o Electronic speed control responds quickly to varying household demand. o Digital voltage regulation protects your valuable electronics quality. harmonic distortion and unstable power The Kohler® Advantage • High Quality Power Two-line, backlit LCD screen is easy to read in all lighting Kohler home generators provide advanced voltage and conditions, including direct sunlight and low light. frequency regulation along with ultra-low levels of • Engine Features harmonic distortion for excellent generator power quality to o Powerful and reliable 2.2 L turbocharged liquid-cooled protect your valuable electronics. engine o Electronic engine management system. • Extraordinary Reliability o Simple field conversion between natural gas and LPG Kohler is known for extraordinary reliability and fuels while maintaining emission certification. performance and backs that up with a premium five-year or . Innovative Cooling System 2000 hour limited warranty. Electronically controlled fan speeds minimize generator • All-Aluminum Sound Enclosure set sound signature. • Certifications • Quiet Operation i The 60 Hz generator set engine is certified by the Kohler home generators provide quiet, neighborhood- Environmental Protection Agency (EPA)to conform to the friendly performance. New Source Performance Standard (NSPS)for stationary spark-ignited emissions. o UL 2200/cUL listing is available (60 Hz only). o CSA certification is available(60 Hz only). o Accepted by the Massachusetts Board of Registration of Plumbers and Gas Fitters. • Approved for stationary standby applications in locations Generator Set Ratings served by a reliable utility source. Standby Ratings Natural Gas LPG ARemator Voltage Ph Hz kW/kVA Amps kW/kVA Amps 4E5.6 120/240 1 60 30/30 125 30/30 125 120/208 3 60 30/37 104 30/37 104 127/220 3 60 30/37 98 30/37 98 120/240 3 60 30/37 90 30/37 90 4D8.3 277/480 3 60 30/37 45 30/37 45 220/380* 3 50 25/31 47 25/31 47 230/400 3 50 25/31 45 25/31 45 240/416* 3 50 25/31 43 25/31 43 * 50 Hz models are factory-connected as 230/400 volts.Field-adjustable to 220/380 or 240/416 volts by an authorized service technician. RATINGS.All three-phase units are rated at 0.8 power factor,All single-phase units are rated at 1.0 power factor.Due to manufactuhng variations,the ratings tolerance is_,5%. Standby Ratings:Standby ratings apply to installations served by a reliable utility,source.The standby rating is applicable to varying loads with an average load factor of 80%for the duration of a power outage.No overload capacity is specified for this rating.Ratings are in accordance with ISO-3046/1.BS 5514,AS 2789,and DIN 6271.GENERAL GUIDELINES FOR DERATING.Altitude:Derate 1.3%per 100 In(328 ft.)elevation above 200 in(656 ft.).Temperature:Deate 3.0%per 10'C(18'F)temperature above 25`C(77`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 arty obligation or liability whatsoever Contact your local Kohler generator distributor to(availability. G4-229 (30RCL) 4/16 i Alternator Specifications Specifications Alternator • NEMA MG1, IEEE,and ANSI standards compliance for Manufacturer Kohler temperature rise and motor starting. Exciter type Brushless,Wound-Field • Sustained short-circuit current of up to 300%of the rated Leads:quantity,type current for up to 10 seconds. 4E5.6 4,120/240 4D8.3 12,Reconnectable • Sustained short-circuit current enabling downstream circuit Voltage regulator Solid State,Vohs/Hz breakers to trip without collapsing the alternator field. Insulation: • Self-ventilated and drip-proof construction. Material Class H Temperature rise 130°C,Standby • Windings are vacuum-impregnated with epoxy varnish for Bearing:quantity,type 1,Sealed dependability and long fife. Coupling Flexible Disc Amortisseur windings Full • Superior voltage waveform from a two-thirds pitch stator and Voltage regulation,no-load to full-load ±1.0%Maximum skewed rotor. Unbalanced load capability 100%of Rated Standby e Total harmonic distortion (THD)from no load to full load with Current 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 4E5.6(4 lead) 44 (60 Hz) 480 V,400 V 4D8.3(12 lead) 120(60 Hz) 88(50 Hz) Application Data Engine Exhaust Engine Specifications 60 Hz 50 Hz Exhaust System 60 Hz 50 Hz Manufacturer Kohler Exhaust manifold type Dry Engine:model,type Residential Powertrain Exhaust temperature at rated kW,dry KG2204T,2.2 L,4-Cycle exhaust, °C(°F) 633(1171) Turbocharged Maximum allowable back pressure, Cylinder arrangement In-line 4 kPa(in.Hg) 7.5(2.2) Displacement,L(cu.in.) 2.2(134.25) Bore and stroke,mm(in.) 91 x 86(3.5 x 3.4) Fuel Compression ratio 10.5:1 Fuel System Piston speed,m/min.(ft./min.) 310(1016) 258(847) Main bearings:quantity,type 5,plain alloy steel Fuel type Natural Gas or LPG Rated rpm 1800 1500 Fuel supply line inlet 1 in.NPT Max.power at rated rpm,kW(HP) Natural gas fuel supply pressure,kPa LPG 47.8(64.1) NA (in.H2O) 1.24-2.74(5-11) Natural Gas 47.6(63.9) NA LPG vapor withdrawal fuel supply Cylinder head material Cast Iron pressure,kPa(in.H2O) 1.24-2.74(5-11) Piston type and material High Silicon Aluminum Fuel Composition Limits• Nat Gas LP Gas Crankshaft material Nodular Iron Methane,%by volume 90 min. — Valve(exhaust)material Forged Steel Ethane,%by volume 4.0 max. — Governor type Electronic Propane,%by volume 1.0 max. 85 min. Frequency regulation,no-bad to Propene,%by volume 0.1 max. 5.0 max. full-load Isochronous C4 and higher,%by volume 0.3 max. 2.5 max. Frequency regulation,steady state ±1.0% Sulfur,ppm mass 25 max. Frequency Fixed Lower heatingvalue, Air cleaner type Dry MJ/m3(Btu/ft ,min. 33.2(890) 84.2(2260) Engine Electrical Fuels with other compositions may be acceptable.If your fuel is outside the listed specifications,contact your local distributor for Engine Electrical System further analysis and advice. Ignition system Electronic Battery charging alternator: Lubrication Ground(negative/positive) Negative Lubricating System Volts(DC) 14 Type Full Pressure Ampere rating 90 Oil pan capacity,L(qt.) 4.2(4.4) Starter motor rated voltage(DC) 12 Oil added during oil change(on average), Battery,recommended rating for-18°C(0°F): L(qt.) 3.3(3.5) Qty.,cold cranking amps(CCA) One,630 Oil filter:quantity,type 1,Cartridge Battery voltage(DC) 12 Oil cooler Remote Battery group size 24 G4-229 (30RCu 4/16 Application Data Cooling RDC2 Controller Radiator System 60 Hz 50 Hz Ambient temperature,°C(OF) 45(113) Engine jacket water capacity,L(gal.) 2.65(0.7) Radiator system capacity,including vas: 240V engine,L(gal.) 13.2(3.5) FMQ: 00.0 Hz Water pump type Centrifugal O Fan diameter,mm(in.) qty.3 @ 406(16) v ®O no 0 ®v Fan power requirements(powered by III •� •• engine battery charging alternator) 12VDC, 18 amps each Operation Requirements Air Requirements 60 Hz 50 Hz The RDC2 controller provides integrated control for the Radiator-cooled cooling air, generator set, Kohler®Model RXT transfer switch, m3/min.(scfm); 51 (1800) 51 (1800) programmable interface module(PIM),and load management. Combustion air,m3/min.(cfm) 1.6(57) 1.3(45) Air over engine,m3/min.(cfm) 25(900) 25(900) The RDC2 controller's 2-line LCD screen displays status t Air density=1.20 kg/m3(0.075 Ibm/ft3) messages and system settings that are clear and easy to read, Fuel Consumption= even in direct sunlight or low light. Natural Gas,m3/hr.(cfh)at%load 60 Hz 50 Hz RDC2 Controller Features 100% 12.0 (424) 10.0 (353) a Membrane keypad 75% 9.8 (345) 8.2 (289) 50% 7.6 (268) 6.3 (222) o OFF,AUTO,and RUN push buttons 25% 5.5 (196) 4.5 (159) o Select and arrow buttons for access to system Exercise 3.4 (121) 2.8 (99) configuration and adjustment menus LP Gas,m3/hr.(cfh)at%load 60 Hz 50 Hz • LED indicators for OFF,AUTO, and RUN modes 100% 4.7 (166) 3.9 (138) • LED indicators for utility power and generator set source 75% 3.7 (132) 3.0 (105) availability and ATS position (Model RXT transfer switch 50% 2.8 (100) 2.3 (81) required) 25% 1.9 (69) 1.6 (56) • LCD screen Exercise 1.2 (41) 1.0 (35) o Two lines x 16 characters per line $ Nominal Fuel Rating: Natural gas,37 MJ/m3(1000 Btu/ft3) c Backlit display with adjustable contrast for excellent LP Vapor,93 MJ/m3(2500 Btu/ft3) visibility in all fighting conditions LP vapor conversion factors: 8.58 ft.3=1 lb. • Scrolling system status display 0.535 m3=1 kg. o Generator set status 36.39 ft.3=1 gal. o Voltage and frequency o Engine temperature Sound Enclosure Features o Oil pressure • Sound-attenuating enclosure uses acoustic insulation that o Battery voltage meets UL 94 HF1 flammability classification and repels o Engine runtime hours moisture absorption. • Date and time displays • Internally mounted critical silencer. • Smart engine cooldown senses engine temperature • Skid-mounted,aluminum construction with two removable • Digital isochronous governor to maintain steady-state speed access panels. at all loads • Fade-,scratch-,and corrosion-resistant Kohler®cashmere • Digital voltage regulation: ±1.0%RMS no-load to full-load powder-baked finish. • Automatic start with programmed cranking cycle Sound Data • Programmable exerciser can be set to start automatically on any future day and time, and to run every week or every two Model 30RCL 8 point logarithmic average sound levels are weeks 54 dB(A) during weekly engine exercise and 61 dB(A) during • Exercise modes full-speed generator diagnostics and normal operation. For o Unloaded exercise with complete system diagnostics comparison to competitor ratings,the lowest point sound levels o Unloaded full-speed exercise are 52 dB(A)and 60 dB(A) respectively.* o Loaded full-speed exercise(Model RXT ATS required) All sound levels are measured at 7 meters with no load. • Front-access mini USB connector for SiteTech- connection Lowest of 8 points measured around the generator.Sound levels at other points • Integral Ethernet connector for Kohler®OnCue®Plus around generator may vary depending on installation parameters. • Built-in 2.5 amp battery charger • Remote two-wire start/stop capability for optional connection of a Model RDT transfer switch See additional controller features on the next page. G4-229 (30Rc1.) 4/16 KOHLER CO.,Kohler,Wisconsin 53044 USA Kohler Power Systems Phone 920-457-4441,Fax 920-459-1646 Asia Pacific Headquarters For the nearest sales and service outlet in the 7 Jurong Pier Road US and Canada,phone 1-800-544-2444 Singapore 619159 KOHLERPower.com Phone(65)6264-6422,Fax(65)6264-6455 Additional RDC2 Controller Features Available Options, Continued • Diagnostic messages Starting Aids§ o Displays diagnostic messages for the engine,generator, ❑ Block Heater,120 V, 1 Ph Model RXT transfer switch, programmable interface ❑ Block Heater,240 V, 1 Ph module(PIM),and load management device ❑ oil Pan Heater, 120 V,1 Ph o Over 70 diagnostic messages can be displayed ❑ Oil Pan Heater,240 V, 1 Ph • Maintenance reminders § One block heater or oil pan heater is recommended for ambient • System settings temperatures below 0°C(32°F). At temperatures below-1 WC(0°F), o System voltage,frequency, and phase installation of both heaters is recommended. o Voltage adjustment Automatic Transfer Switches and Accessories o Measurement system, English or metric ❑ Model RDT Automatic Transfer Switch • ATS status(Model RXT ATS required) ❑ Model RXT Automatic Transfer Switch o Source availability ❑ Model RXT Automatic Transfer Switch with Combined o ATS position(normal/utility or emergency/generator) Interface/Load Management Board o Source voltage and frequency ❑ Load Shed Kit for RDT or RXT • ATS control (Model RXT ATS required) ❑ Power Relay Modules(use up to 4 relay modules for each o Source voltage and frequency settings load management device) o Engine start time delay Miscellaneous o Transfer time delays ❑ Rated Power Factor Testing o Fixed pickup and dropout settings Uterature o Voltage calibration ❑ General Maintenance Literature Kit • Programmable interface module(PIM)status displays ❑ Overhaul Literature Kit o Input status(active/inactive) ❑ Production Literature Kit o Output status(active/inactive) warranty • Load control menus ❑ Extended 5-Year/2000 Hour Comprehensive Limited Warranty o Load status Other options o Test function ❑ Generator Set Standard Features ❑ • Aluminum sound enclosure with enclosed silencer • Battery rack and cables Dimensions and Weights • Electronic, isochronous governor Overall Size,L x W x H,mm(in.): 1880 x 836 x 1169 • Flexible fuel line (74 x 32.9 x 46.0) • Gas fuel system (includes fuel mixer,electronic secondary Shipping Weight,wet,kg(lb.): 599(1320) gas regulator,two gas solenoid valves,and flexible fuel line Weight includes generator set with engine fluids, sound enclosure, between the engine and the skid-mounted fuel system silencer,and packaging. components) • Integral vibration isolation • Line circuit breaker • Oil drain extension • OnCue®Plus Generator Management System H • Operation and installation literature • RDC2 controller with built-in battery charger • Standard five-year or 2000 hour limited warranty Available Options Approvals and Listings NOTE:This drawing is provided for reference only and should not be used for planning installation.Contact your local distributor for more UL 2200/cUL Listing(60 Hz only) detailed information. CSA Approval(60 Hz only) DISTRIBUTED BY- Controller Accessories ] Programmable Interface Module(PIM) (provides 2 digital inputs and 6 relay outputs) Electrical System ❑ Battery ❑ Battery Heater ©2016 by Kohler Co.All rights reserved. G4-229 (30RCL) 4/16 E cn 0 -0 L c t a) �n � a) 0) O cn L O O •X D a) 0 O (n C L (Q L a) E n- o O in - L c L 0 '~ a) 0) U) o ca c E � cu o E � � ( Y U.) C L a) ^a) }' 0 O 1 W L 0— CD 0 O O O C/) O E () O N 735, .0 O a) L M m (V 00 O O (6 X N U (� a) EO _0rnEL E ' cn ag a) Q Q ,hi i F e � ; - a m d a cow., r 9 Westchester County Electrical Licensing Board Westchester County Consumer Ptotertlon Master Electrician License 2021 Joseph D Covais SR D.O.B:11/2911956 Company: Baldwin Electric Corp r`. 26 Kiscona Road , Mount Kisco,NY 10649 .i1 c � it License No.463 Expireson:1213112021 PeterBorducci C n ® DATE(MMIDDIYYYY) A C" CERTIFICATE OF LIABILITY INSURANCE 05/2112021 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 CONTACT NAME: ALEXIS ANN SALUBRO Albert Palancia Agency, Inc. PHONE (914)698-1375 No:(914)698-0125 PO Box 26 E-MAIL ADDRESS: alexispalanciainsurance.com Mamaroneck, NY 10543 INSURERS AFFORDING COVERAGE NAICf INSURERA: Merchants Mutual Insurance Company 23329 INSURED INSURERS: Hartford Ins.Co. of the Midwest 34690 BALDWIN ELECTRIC CORP INSURERC: ShelterPoint Life Insurance Company 81434 26 KISCONA RD INSURER D: MT KISCO, NY 10549-2606 INSURER E: -INSURER F COVERAGES CERTIFICATE NUMBER: 10000931-2973242 REVISION NUMBER: 362 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 ADDTYPE OF INSURANCE L SUBR POLICY NUMBER M POLICY DDIYYYY D POLICY LTR MMD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y BOP1097768 01/01/2021 01/01/2022 EACH OCCURRENCE $ 1000000 CLAIMS-MADE 41 OCCUR R MISES Ea occurrence $ 600,000 MED EXP(Any one person) $ 15 000 PERSONAL BADVINJURY $ 1 000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY� OTHER: $ A AUTOMOBILE LIABILITY CAP1062160 01101/2021 01/01/2022 (Eaasodden SINGLE LIMIT BILI $ 1,000,000 IXANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY X AUTOS ONLY (Per accident A X UMBRELLA UAB X OCCUR CUP9149463 01/01/2021 01/01/2022 EACH OCCURRENCE $ 4,000,000 EXCESSLIAB CLAIMS-MADE AGGREGATE $ 4,000,000 DED X RETENTION$ 10 00O 1 1 $ B WORKERS COMPENSATION 16WECEV8751 01/01/2021 01/01/2022 X AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N E.L.DISEASE-EA EMPLOYEE $ 1,000,000 IDESCes R describe under PTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C DISABILITY D428417 01/02/2021 01102/2022 STATUTORY DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as Additional Insured with respect to General Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Village of Rye Brook ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street RYE BROOK, NY 10573 AUTHORIZED REPRESENTATIVE (AAS) 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by AAS on May 21.2021 at 01 12PM rNCE JI workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured BALDWIN ELECTRIC CORP. 914-666-8899 26 KISCONA ROAD MOUNT KISCO,NY 10549 1c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e.,Wrap-Up Policy) 133704004 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Village of Rye Brook 938 King Street 3b.Policy Number of Entity Listed in Box"1 a" Rye Brook, NY 10573 DBL428417 3c.Policy effective period 01/02/2021 to 01/01/2022 4. Policy provides the following benefits: © A.Both disability and paid family leave benefits. B.Disability benefits only. ❑ C.Paid family leave benefits only. 5. Policy covers: © A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: 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 NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. 4 4f Date Signed 5/21/2021 By C�� IY/ (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White, Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked, and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220, Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board (Only if Box 4C or 56 of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1.Insurance brokers are NOT authorized to issue this form. DB-120.1 (10-17) II II 1IIIIIII DB-120.1 (10-17) Workers' STA CERTIFICATE OF TE Compensation Board NYS WORKERS COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of Insured (914)666-8899 BALDWIN ELECTRIC CORP 26 KISCONA RD 1 c.NYS Unemployment Insurance Employer Registration Number of MT KISCO,NY 10549-2606 Insured Work Location of Insured(Only required if coverage is specifically limited to 1d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 13-3704004 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Hartford Ins.Co.of the Midwest Village of Rye Brook 3b.Policy Number of Entity Listed in Box"1 a" 938 King Street 16WECEV8751 Rye Brook,NY 10573 3c.Policy effective period 01/01/2021 to 01/01/2022 3d.The Proprietor,Partners or Executive Officers are ❑ included.(Only check box if all partners/officers included) ❑X all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box 1 a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to 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: Joseph T.Palancia (Print name of authorized representative or licensed agent of insurance carrier) Approved by: =~ 1c-L u Zhu Signature) (Date) Title: Agent Telephone Number of authorized representative or licensed agent of insurance carrier: (914)698-1373 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-17) www.wcb.ny.gov Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. C-105.2(9-17) REVERSE EVILLAAGE EE�M� BUILDING DEPARTMENT VILLAGE OF RYE BROOK13 2021 938 KING STREET RYE BROOK,NY 10573F(914)939-0668 FAx(914)939-5801 RYE BROOK wwwxyebrook.or EPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: Approval Date: Permit Fee: $ a Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, 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 electrical equipment, wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. I.Address: SBL: /2 48 4—5�o�5 Zone: 2.Property Owner: ao tid �lA ki, Address: tmjU Phone#:q/7 -1 -- �.1a8 Cell#: I� I `� email: t- D S6n$ @_T-e.LBuL).6cM 3.Master Electrician: 4_D.Sc5oh .00✓Atf, Address: l�cf ii Lic.#: Phone#:9N46 --8SI94 Cell#: email: Company Name: Z¢ dw k) L-leeTere Address: —1/. I&C1 00l9 FO W. x/�SCD 4.Proposed Electrical Work/Fixture Count: �I,Ci'�JG ai�7 6h e e 304 Q GTgk6re0 rL t el' ar off' a-0 TcG, STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,J'6bgoA D. N tfmi� being duly sworn,deposes and states that he/she is the applicant above named,and does further (print nan e of individual signing as the applicant) /� state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the f�( C CoNTG�/a for the legal owner and is duly authorized to make and file this application. (h,dirrtr archucrt.contractor.agrnt.auornc .clr i The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,an7 irat 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 the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to b fore me this_ �0.�_. day o 20 of �. 10'1 e, ,20a I Sign ure of P rty Owner Si ature of Applicant �...l o` �ok���� va ry Pri ttName of Prop Owner Print Name of ppl t Notary Public Notary Public UDC 0 b (o&7q q CAROL ANN PRIORE Notary Public Connecticut My Commission Expires May 31,2025 3/21/19 s ` 1,r r \ � 1.J-...' \t .« -. • -. rS�` +'. .'t'T 1" f' '�`�'�� ,.'�,aYr."� '. � .,t.4 . i F it•�• ., \., ,a, . ,�- VIA.' �'-aro..t.•v�•y.•�.: '\ �N sR t'O/:�' 72"ir1��J+' Westchester County Electrical Licensing Board Westchester County Consumer pr6taetion Master Electrician License 2021 Joseph 0 Covais SR 0.0.6:11/2911966 Company: •� Baldwin Electric Corp r 26 Kiscona Road Mount Kisco,NY 10649 .new License No.463 =1 Expires on:1213112021 Peter Borducci A`oRV® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/21/2021 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 CONTACT Albert Palancia Agency, Inc. PHONE ALEXIS ANN SEnan E PO BOX 26 EVIL (914)698-1373J125 ADDRESS: alexis@palanciainsurance.com Mamaroneck, NY 10543 INSURER(S)AFF INSURER A: Merchants MutCompany INSURED INSURERB: Hartford Ins.BALDWIN ELECTRIC CORP INSURERC: ShelterPoint Li 26 KISCONA RD INSURER D: MT KISCO, NY 10549-2606 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 10000931-2973242 REVISION NUMBER: 362 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 ADDL SUBR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP INSD WVD POLICY NUMBER MM DDIYYYY MM DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY y BOP1097768 01/01/2021 01/0112022 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Ek OCCUR PREMISES(Ea occurrence) $ 500 000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PEC LOC PRODUCTS-COMP/OP AGG $ 2 000 000 OTHER: E A AUTOMOBILE LIABILITY CAP1062160 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO Ea awdent BODILY INJURY(Per person) $ OWNED SCHEDWN ULED AUTOS ONLY X AUTOS BODILY INJURY(Per accident) 3 X AUTOS ONLY X AUHIRED TOS ONLY PROPERTY DAMAGE er acddent $ $ A X UMBRELLA LIAR X OCCUR CUP9149463 01/01/2021 01/01/2022 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 DED X RETENTION E 1 O O00 $ MRKERS COMPENSATION B AND EMPLOYERS'LIABILITY YIN 16WECEV8751 01/01/2021 01/01/2022 X STATUTE ER ANYPROPRIETOR/PXCLUD/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 (Mandatory ER EXCLUDED? NIA (Mandatory in If under es,tlescnbe a under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT E 1,000,000 C DISABILITY D428417 01/02/2021 01/02/2022 STATUTORY DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as Additional Insured with respect to General Liability 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 ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street RYE BROOK, NY 10573 AUTHORIZED REPRESENTATIVE I -)"'-et (7,- P- L-f - (AAS) D 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by AAS on May 21,2021 at 01:12PM voeK Workers' CERTIFICATE OF INSURANCE COVERAGE STATE Compensation Board DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW PART 1.To be completed by Disability and Paid Family Leave Benefits Carrier or Licensed Insurance Agent of that Carrier 1a. Legal Name&Address of Insured(use street address only) 1b. Business Telephone Number of Insured BALDWIN ELECTRIC CORP. 914-666-8899 26 KISCONA ROAD MOUNT KISCO,NY 10549 1c.Federal Employer Identification Number of Insured Work Location of Insured(Only required if coverage is specificallylimited to or Social Security Number certain locations in New York State,i.e.,Wrap-Up Policy) 133704004 2. Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Village of Rye Brook 938 King Street 3b. Policy Number of Entity Listed in Box"1 a" Rye Brook, NY 10573 DBL428417 3c.Policy effective period 01/02/2021 to 01/01/2022 4. Policy provides the following benefits: 0 A. Both disability and paid family leave benefits. B. Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: 0 A.All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. B.Only the following class or classes of employer's employees: 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 NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 5/21/2021 By ��d4t (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Richard White Chief Executive Officer IMPORTANT: If Boxes 4A and 5A are checked, and this form is signed by the insurance carder's authorized representative or NYS Licensed Insurance Agent of that carrier, this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B, 4C or 5B is checked, this certificate is NOT COMPLETE for purposes of Section 220, Subd. 8 of the NYS Disability and Paid Family Leave Benefits Law. It must be mailed for completion to the Workers'Compensation Board, Plans Acceptance Unit, PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers' Compensation Board (Only if Box 4C or 5B of Part 1 has been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board, the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law with respect to all of his/her employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form DB-120.1. Insurance brokers are NOT authorized to issue this form. D13-120.1 (10-17) I j i III I D13-120. 1 (10-17) vORRK workers' CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured BALDWIN ELECTRIC CORP (914)666-8899 26 KISCONA RD MT KISCO, NY 10549-2606 1 c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State, i.e.,a Wrap-Up Policy) 1d.Federal Employer Identification Number of Insured or Social Security Number 13-3704004 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Hartford Ins.Co.of the Midwest Village of Rye Brook 938 King Street 3b. Policy Number of Entity Listed in Box"la" Rye Brook,NY 10573 16WECEV8751 3c.Policy effective period 01/01/2021 to 01/01/2022 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"3"insures the business referenced above in box 1 a"for workers' compensation under the New York State Workers' Compensation Law. (To use this form,New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form, if the business continues to 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: Joseph T.Palancia (Print name of authorized representative or licensed agent of insurance carrier) Approved by: '(Date) (Date) Title: Agent Telephone Number of authorized representative or licensed agent of insurance carrier: (914)698-1373 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov