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HomeMy WebLinkAboutMP24-008 QyC BR� K VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E.Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE September 19, 2024 Michael Vasaturo,Antonietta Vasaturo&Jaclyn Bryant 161 Brush Hollow Crescent Rye Brook,New York 10573 Re: 161 Brush Hollow Crescent,Rye Brook,New York 10573 Parcel ID#: 129.76-1-99 This document certifies that the work done under Mechanical Permit#24-008 issued on 1/12/2024 for the installation of a new condenser,new air handler and new oil fired boiler has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to a�yE BRC��. Zm w � 1982 BUILDING DEPARTMENT ❑yBUILDING INSPECTOR {a 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" U 5 DATE: l t PERMIT# L -I d 7 J ISSUED: SECT: i BLOCK: LOT: LOCATION: GM -1 G�K� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... D" ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER 14.V. (_ 00 a y O o N d' N N W 00 CIA Q �' Nr M en acn O C ? ° . C Z o O � � � A 120-14 _ „ 00 14 , a ay . O Q V Z wvvo � o o o l t o u a poll A C7 c C,) � > 8 a = a te Q W M �� �/'wL� a r� o f + F+6 � � n u p'w V• F/y�,l � vi � v 0, O O z ►-� M N > U � O A � ,�� O °•" U z °" °aab � ep 40, 1-4 cn V V O En z dd P, op O b = 0 0 U U W � O 0. a � a _ BUILDING DEPARTMENT D IECEWED VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 JAN 11 2024 (914), 9-0668 o k.or VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: WI=Yj`00F r Approval Date: JA� 1 Z� Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ++++++,r++++++++++++r++t+*++++++++f+re+,►*+f*++++r++*+,r++++*+**+++t+,t+,t+*t,t+*+*+*t++*+r**t,r++t+++++#+++++ DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: I. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (village or Rye Brook must be listed as certificate holder) & Workers Compensation Insurance on a NYS Board form (Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL = $100.00/unit • COMMERCIAL =$350.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required 7. Electrical work requires a separate Electrical Permit&Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, 12/29/23 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. I. Address: 161 Brush Hollow Crescent, Rye Brook, NY SBL: /C) 91 76—/— `!zone: 2. Property Owner: Jaclyn Bryant Address: 161 Brush Hollow Crescent, Rye Brook, NY Phone#: 203`04 -4118 Cell#: 203-494-4718 email:�aG►1nVa5nlUro@9V-VL;k,cor- 3. Contractor: Keep It Cool, Inc Address: 363 Elwood Ave, Hawthorne, NY 10532 Phone#: 914-741-5055 Cell#: 914-760-4810 email: mikemcc@keepitcoolinc.com 4. Scope of Work:New Installation( )•Replacement VRemoval( )•Other( ): S. List Equipment: 3 Tnn Anana A/C Air HanrilPr 3 Tnn Amnna A/C CnndPnsPr Burnham, Oil Fired Hot Water Boiler, 170 MBH. 6. Location of Equipment: A/C Air Handler is located in the attic,A/C Condenser is located on the side of the house The boiler is located in the mechanical at the rear of the house 7. Method of Installation/Removal(list all equipment needed toperrorm;eb): The new air handler will replace the old air handle that is located in the attic. The New Condenser will replace the old condenser that is located on the side of the house. The new boiler will replace the old boiler located in the mechanicl room 1 10/3012©23 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Michael McCarvill ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 71 `f% Sworn to before me this 10 day of natm 19,y' ,202.3 aignature kofAppliciant 20 S at re of F operty Owner �aGl grYan Michael McCarvil1 Print Name of Property Owner Print N It Notary Public Notary Pu mj Comm-tssluYr expilwn, �12,0Iz-7 EPHYLLIS TACKET Notary Public—State of New York NO 01TA5053093 Qualified in Westcheslpr County My Commission Expires Dec 11,202� This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. 2 10/30/2023 Ow O F W �y WE O 3 2 r., 2r� k u � lb y�•O� �b ° �l°^i ` C p C � �c � a p g 8 yR, o °m 4 V Ri `s Z4° a 333 'o O n air ��o� �`• � ° bZ yam. °yuo o, A •�at„� � � �s` (n L�N Z ^�i. E °�n c°nm W� 4'v'i7�uc � o agE;nQu � s�9� • �O jJ U o y ) m+Q hU C S�SS R N Boa' eh� Fg�i Lot '60 RATI h FM OWrie 93462) . 5� 10 , p RePute(ddoc, no 94 j}0 W "E Z V ,00 d,dGn9 °0"` '° 52pr0� r V 0 V A 149 1 1/' ►n9 O QR A �ki 5£SeafiS°3obh �7 N p s,e=N:a§S1 S��� �t o Lj Q a < �zoa�aae�� NO ,� �( .ao.�<$�,yy�Cy�*£ —.` >e5. .1& .5 to V � v°rn 'c ogu� e pNQ cWZ N "q) 3 Omg Uu 8 c �ev�y° Oay`ac°, u O�UU E C o 3 H.LMON 3711 $ls {a{ i ? Bouruha m I 8I r I IIcle E nt UPGRADEARIE 87% 'I Fi red,ired, Chimney Vented, See back for ' SCast Iron Boiler i 86%AFUE ENERGY STAR",-certified 87%AFUE available with upgrade kit (see back for details) Cast iron sectional design Seven sizes available, 1.00-2.60 GPH Optional tankless water heater Multiple oil burner options for water boilers (Beckett, Carlin), includes burner cover for quiet operation Durable push-nipple connections between boiler sections—will not deteriorate when exposed to petroleum-based antifreeze Easy to clean and service—side and top cleanouts provide complete access to flueways Full swing-away burner door Lifetime limited warranty Intelligent Oil Boiler Control • Standard on V8H water boilers' • Combines aquastat and relay functions into a single module • Two customizable integrated switching relays for easy addition of additional heating zone or indirect water heater • Energy saving "thermal purge", which works by Bu r n h a s t circulating residual ����,�; warm water(140°or b above) in the heating Boiler Comma system before firing the boiler Is • LED display for boiler status and trouble codes • Extensively tested and proven in thousands of LOYou existing installations W (L.. 'Optional Hydrolevel hydronic control available on some models V8H: Technical InformationE oy H Intartek Standard Equipment V8H Ratings : Spippifications • Cast iron section assembly:Wet base construction. Burner DOE Approx. quick release top outlet canopy,removable right side Capacity Heating Net Ship flue plates Capacity' AHR13 AFUE Steam Wt. • Intelligent Oil Boiler Control System(water only) MBH Model No. GPH MBH' • Cast iron swing door (MBH) (MBH)) (Sq. Ft.) (Ibs.) • Flange mounted retention oil burner + V81­13WE 1.00 140 1 120 104 86.0 1 - 534 • Insulated deluxe jacket with lift-off side panel V8H4WE 1.20 170 148 129 86.1 - 643 • Boiler drain valve V8H5WE 1.65 231 200 174 86.0 - 763 • Safety relief valve • Pressure temperature gauge V8H6WE 1.90 266 230 200 86.0 - 883 • High limit&relay V8H7WE 2.10 294 255 222 86.1 - 1003 • Draft regulator V8H8S 266' 200 81.41 833 1121 • Gauge glass set(steam only) 2.35 329 • Steam gauge(steam only) V8H8W 275' 239 82.01 - 1121 • Probe-type LWCO(steam only) V8H9S 298' 224 82.35 933 1245 • 8 and 9 section models always shipped as V8H9W 2.60 364 2991 260 82,35T 2.35 - 1245 individually crated knock-downs NOTES MODEL NUMBER NOTES: (1) MBH refers to thousards of BTU per hour Add"H"suffix to model numbers for Hydrolevel Hydrostat control(where available) (2) Based on standard test procedure by the U.S.Department of Eneregy at combustion conditions of 13.0%CO, Add"T"suffix to selected model numbers fo•Tarkless DHW coil (3) Ratirgs are based on p ping and pickup allowance of 1.15 to,water Packaging Availability(prefix):P=Packaged,Assembled in crate(sec 3-7). (4) Gross output KD=Knockdown(sec.3-7). CK=Crated Individual Knockdown(sec.8,9) (5) Thermal efficiency Energyrr .t +rels-Ki%J,Ratings Dimensions r Burner Capacity DOE Diameter Rectangle Height Heating Net , Upgrade Size 'A' 'B' `C' (In.) (In. x In.) (Feet) Model No. Capacity AHRI AFUE Kit V8H3 17-1/8 9-1/8 6 6 8 x 8 15 (W-Water) GPH MBH (MBH) (MBH) % Required V81­14 22-1/8 11-5/8 6 6 8 x 8 15 V8H3WES 0.90 126 109 95 87.0 110333-03 V8H4WES 1.20 170 148 129 87.0 110333-03 V81­15 27-1/8 14-1/8 7 7 8 x 8 15 V8H5WES 1.55 220 190 165 87.0 110333-05 V81­16 32-1/8 16-5/8 7 7 8 x 8 15 V8H6WES 1.85 260 224 195 87.0 110333-05 V81­17 37-1/8 19-1/8 8 8 8 x 8 15 V8H7WES j 2.10 287 249 217 87.2 110333-07 V8H8 42-1/8 21-5/8 8 8 8 x 12 15 Upgrade<its available for standard boilers without"S"in model numbers V8H9 47-1/8 24-1/8 8 1 9 8 x 12 15 :] Only available for Beckett and Carlin burners 24" 24 VBH Service Clearance (on Service Clearance t 6-1/8` (only if flueways are to be (only if ffrom t s are to be cleaned from the top) U.Scleaned from the side) BoderConfluairry Relief Valve A 3114 9-5/8" B 3-4-1 1-112"supply- Diameter Flue Colla- Temp./Pressure Gauge -- -� 0 Cold Start Boiler Burner Disconnect Control - Junction Box Flame Observation Port 32.1/4' Floor Line 2.1/2' 17 19" 1-1'2"Return= 24" Burne•Swing Door Front Service Clearance Clearance(Fully Open) Form No.PL81401281000-7.5ms www.usboiler.net Boiler Company Printed in the U.S.A. ©2020 U.S.Boiler Company.Inc.-Lancaster,PA Phone: 1-888-432-8887 duti g 6 Air Condldoning IF Ma�a ASXH5 AMERICA'S BRAND FOR COMFORT HIGH-EFFICIENCY SPLIT SYSTEM AIR CONDITIONER UP TO 17 SEER2 1% To 5 ToNs Contents Nomenclature........................................2 Product Specifications...........................3 Expanded Cooling Data.........................4 Performance Data...............................18 Dimensions..........................................19 Wiring Diagrams .................................20 - Accessories..........................................23 Standard Features Cabinet Features • High-efficiency Copeland scroll compressor • Removable grille-style top design • Advanced Copeland CoreSense technology compliant with UL 60335-2-40 • High-density foam compressor sound blanket • Heavy-gauge galvanized-steel cabinet • Factory-installed filter drier • Baked-on powder-paint finish with • High and low pressure switches 500-hour salt-spray approval • Copper tube/enhanced aluminum fin coil • Steel louver coil guard with Rust-resistant screws • Fully charged for 15'of tubing length • Top and side maintenance access • Service valves with sweat connections • Single-panel access to controls with space and easy access to gauge ports provided for field-installed accessories • Contactor with lug connection • When properly anchored it meets the 2020 Florida • Ground lug connection Building Code unit integrity requirements for • AHRI Certified;ETL Listed hurricane-type winds(Anchor bracket kits available.) ov(T . ® rli delt ai,my wrtN,,.QL cenl�SYDOWall. .raoaoot• .00,.W. Intertek Proper sting and installation of equipment is critical to • ' Corplete warranty details available from yo,u local dealer or at achieving optimal performance.Split system air conditioners LP or a[ru� r PART$ www.amana-hac.com.To receive the Lifetime Unit Replacement Limited and heat pumps must be matched with appropriate coil Warranty(good for as long as you own your home)and 10-Year Parts components to meet ENERGY STAR•criteria.Ask your Limited Warranty,online registration must be completed within 60 days contractor for details or visit www.energystacgov. of�nstailatlon.Online regstration Is not requiredn California or 4uAbec. The duration of warranty coverages in Texas differs,n some cases. SS-ASXH5 www.amana-hac.com 06/23 Amana`is a registered trademark of Maytag Corporation or its re'.ated companies and Is used under license Ail rights reserved. 5.persedes 04/22 SPECIFICATIONS 01810A 1 1 1 1 1• 03610A 14 1 14: 1 0.0 1• CAPACITIES Nom ra'Cooling(BTI,/r) 18,000 24,000 30,000 36,00 442,000 748,DOO 60,000 SEER2 15.2 15.2 15.2 15.2 15.2 5.2 15.2 Decibels(d8A) 71 72 71 74 71 72 75 COMPRESSOR P-A 9.0 11.5 12.8 14.1 177 19.9 23.7 LRA 42.6 59.5 65 87.4 110.2 110 151 Stage Single Single Single Sirgle Single Single Two Type SCrO'J Scroll Scroll Scroll Scroll Sc'oI Scroll CONDENSER FAN MOTOR Motor Type PSC PSC PSC PSC PSC PSC ECM Horsepower 1/8 1/6 1/6 1/6 1/4 1/4 1/3 FLA 0.70 0.95 095 0.95 1.30 1.30 2.80 REFRIGERATION SYSTEM Refr gerart Lire Size' Liquid Line Size("O.D.) %" W. %" %" %11 /." Y., Suction Line Size("O.D.) W, Y' /." /." YV Refrigerant Connection Size Liquid Valve Size("O.D.) Y.' Y. Y. W W. Y. Y, Suction Valve Size("O.D.)2,3 W '�" Valve Type Sweat Sweat Sweat Sweat Swea: Sweat Sweat Refrigerant Charge' 64 72 _01 102 177 180 209 ELECTRICAL DATA Voltage-ohase(60 Hz) 208/230-1 208/230-1 208/230-1 208/230-1 208/230-1 208/230-1 208/230.1 Min mum Circuit Ampacity 5 11.9 15,3 17.0 18.6 23.4 26.2 32.4 Max.Overcurrent Protection y 20 25 25 30 40 45 50 Min/Max Volts 197/253 197/253 197/253 197/253 197/253 197/253 197/253 Electrical Conduit Sze G"or''/." %"or Y.." A'or W G"or'/." Y,"or'%" Yz"or''1% %,"or W E4uIPMENT WEIGHT(LOS) 126 151 202 202 260 260 283 SHIP WEIGHT(LOS) '44 169 224 224 282 282 305 ENERGY STAR"CERTIFIED mmm � zlm ME 'Line sizes denoted for 25'line sets,tested and rated in accordance with ARI Standard 210/240.For other line set lengths or sizes, refer to the Installation Instructions and/or the Long Line Set Applications guide. 'Installer will need to supply Y"to Y"adapters for suction line connections. 'Installer will need to supply Y.."to 1Y.."adapters for suction line connections. 'Unit is factory charged with refrigerant for 15'of Y"liquid line.System charge must be adjusted per the Final Charge Adjustment procedure found in the Installation Instructions. s Wire size should be determined in accordance with National Electrical Codes;extensive wire runs will require larger wire sizes "Must use time-delay fuses or HACR-type circuit breakers of the same size as noted. NOTES • A ways check the 5&R plate for electrical data on the unit being irstaCed ENERGY STAR NOTES • Proper s'zing and installation of equipment is critical to achieving optimal performance.split system air conditioners and heat pumps must be matched with appropriate coil components to meet ENERGY STAR criteria. • Ask your contractor for details or visit www,energystar.gov.The www.energystar.gov websae provides up m-date system comomations certified to meet ENERGY STAR requirements. SS-ASXH5 www.amana-hac.com 3 H wtingaAirConditioning ASPT SER/ES a�a MULTI-POSITION, MULTI-SPEED, ECM-BASED AIR HANDLER WITH INTERNAL TXV 1% TOSTONS Contents Air Handler Nomenclature....................2 Heater Kit Nomenclature......................2 Product Specifications...........................3 Dimensions............................................4 Airflow Data...........................................6 Heat Kit Data..........................................8 Wiring Diagram....................................15 Accessories..........................................18 i Product Features • Internal factory-installed thermal expansion • Rigid SmartFrame"cabinet valves for cooling and heat pump applications • Horizontal or vertical • Direct drive,multi-speed ECM blower motor configuration capabilities • All-aluminum evaporator coil • 21"depth for easier attic access • Coil mounting track for quick repositioning • DecaBDE-free thermoplastic drain • Optimized for use with R-410A refrigerant pan with secondary drain connections • Cabinet air leakage less than 2.0%at 1.0 inch H2O • Screw-less sides and back helps to reduce con- when tested in accordance with ASHRAE standard 193 denlation when installed in humid locations • Cabinet air leakage less than 1.4% at 0.5 inch H2O • Foil-faced insulation covers the internal when tested in accordance with ASHRAE standard 193 casing to reduce cabinet condensation • AHRI certified;ETL listed • Galvanized, leather grain-embossed finish • Glue-less cabinet insulation retention • Tool-less filter access • Field Installed 3 kW—25 kW electric heater kits available ooMnwv xtrH caasµr wrrH AP- owunaranr anwonwa raa o BY owv to cmr•eo By er DW t»iv oc .eo I=. .so coot Intertek 'Complete warranty details available from your local dealer or at www.a m a na-hac. corn.To receive the 10•Year Parts Limited warranty,online registration must be completed within 60 days of installation.Online registration is not required in California or Qu6bec. SS-AASPT www.amana-hac.com 9/21 Amana•is a trademark of Maytag Corporation or its related comoanles and used,.nder license to Goodman Company,L.P.,Houston,Texas. Supersedes 12/20 PRODUCT SPECIFICATIONS r •r r NOMINAL RATINGS Cooling(Btu/h) 2/,000 24,000 24,000 28,000 30,000 36,000 36,000 42,000 48,000 60,000 42,000 48,000 60,000 BLOWER Diameter 9Y:" 9%:" 10%" 9W, 9%" 10%,, 10%11 10%" 10'/i' 10%11 10%" 1115/6" 1115/16" Width 6" 6" 8" 6" 6" 8" 8" 10%11 81, 105/e" 10'/" 105/s" 105/s" COIL CONNECTIONS Liquid %11 W, W. %" %' W. %" W. %s" %s" '/s' Suctionu n " a' /8 /5 Coil Drain Connect(FPT) %" '/." '/." %" %" '/." '/." %" '/ %" %" '/." ELECTRICAL DATA Voltage 208/230 208/230 208/230 208/230 208/230 208/230 208/230 208/230 208/230 208/230 208/230 208/230 208/230 Minimum Circuit Ampacity 5.8/5.8 5.8/5.8 4.9/4.9 5.6/5.6 5.6/5.6 5.6/5.6 4.9/4.9 4.9/4.9 7.1/7.1 7.9/7.9 5.6/5.6 8.6/8.6 8.6/8.6 Max.Overcurrent Device 15/15 15/15 15/15 15/15 15/15 15/15 15/15 15/15 15/15 15/15 15/15 15/15 15/15 (Amps) Minimum VAC 197 197 197 197 197 197 197 197 197 197 197 197 197 Maximum VAC 253 253 253 253 1 253 253 253 253 253 253 253 253 253 Blower Motor Full Load Amps(FLA) 4.6 4.6 3.9 4.5 4.5 4.5 3.9 3.9 5.7 6.3 4.5 6.9 6.9 Horsepower(HP) % % % % '/, '/< % % a/. 1 Y/ 1 1 SHIP WEIGHT(LBS.) 1'_6 129 118 129 129 144 118 144 125 144 155 167 167 •Airflow,rate @.3 static Note:Assumes dry coil;SUM correction for wet coil=4%)208V/240V) SS-AASPT www.amana-hac.com 3 KEEPITC-01 BPHINITSOVANNA ACORO CERTIFICATE OF LIABILITY INSURANCE DATE /16/20Y 1016/203 23 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER C NTACT Lori Kirk World Insurance Associates,LLC n/co,"o,Eat: 845 230-3327 323 ac,No 616 Clock Tower Commons Brewster,NY 10509 - I lorikirk@worldinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A Selective Insurance Company of America 12572 INSURED INSURER B: Keep It COOT Inc. INSURER C: 363 Elwood Ave INSURER D Hawthorne,NY 10532-1257 INSURER E. 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 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 1-0 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 ADDLLTR TYPE OF INSURANCE INSD SUER WVD POLICY NUMBER POLICY EFF�ryyl POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE CLAIMS-MADE [X] OCCURX S 2576082 4/17/2023 4/17/2024 DAMAGE TO RENTEPRE D 500,000 MED EXP(Ary one error 15,000 PERSONAL&ADV INJURY 111 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 F1POLICY❑JECO PR - � GENERAL AGGREGATE T LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER: ELITE PAC GL EX A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ANY AUTO S 2576082 4/17/2023 4/17/2024 BODILY INJURY Perperson) OWNED AUTOS SCHEDULED BODILY INJURY Per accident AIURNE ONLY X SCHECU p � AUTOS ONLY AUU O"rjV PPe�acadentDAMAGE X EEElitntldetPacAuto A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 1,000,000 EXCESSLwe ICLAIMS-MADE S 2576082 4/17/2023 4/17/2024 AGGREGATE 1,000,000 DED J X I RETENTION$ 10,000 WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y I N STTITI ER ANY PROPRIIE-ORIPARTNERiEXECUTIVE E.L.EACH ACCIDENTeER/M nNHEXCLUDE NIA (M H yes.describe under E.L.DISEASE-EA EMPLOvE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate holder is additional Insured on a primary and non contributory basis with respect to General Liability for the purpose of issuing licenses or permits. 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 9 y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD fi \\ NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) o 'a ^^^^^^ 133905398 r KEEVILY,SPERO-WHITE LAW INC. 500 MAMARONECK AVENUE HARRISON NY 10528 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER KEEP IT COOL INC VILLAGE OF RYE BROOK 363 ELWOOD AVENUE-SUITE B 938 KING ST. HAWTHORNE NY 10532 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G1302 944-2 220965 05/01/2023 TO 05/01/2024 10/16/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1302 944-2, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE: NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. MICHAEL MCCARVIL-PRES KEEP IT COOL INC 1 OF 1 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. NEW YORK STAT SUR NCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER 135704804 U-26.3