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Home My WebLink AboutMP24-052 J V l�Yt4 VV�� . 1q VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www.iyebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E.Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE May 31,2024 Matthew Bergtraum&Randi Bergtraum 25 Meadowlark Road Rye Brook,New York 10573 Re: 25 Meadowlark Road, Rye Brook,New York 10573 Parcel ID#: 135.28-1-1 This document certifies that the work done under Mechanical Permit#24-052 issued on 4/18/2024 for the installation of a new condenser,coil and furnace has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to Q�E BRC�,�• F o 1982 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.or - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : ..7 ij'I F� C../JR DATE: zC/ PERMIT# t '\ + � ISSUED: /V 1 SECT: BLOCK:_LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ 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 °N '�" G` ❑ FINAL OTHER �.✓.A L . ay C ,��c �E BRO, O� Zm 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 : Z.J lc-/l ' owe /I L) DATE: J®- PERMIT# ISSUED: " '' 'SECT: BLOCK: / LOT: / LOCATION: `-�Ll� r�� , OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ 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 H.114 (. S �� !u i �� . c A' '�M' >k - 1�.' \\�� :.� �� `� �� r �_. r � ,F �` Ee T� • � , I ` �- � � '/., 1, _� r gyp{c I y ` . 1 1 L In �- N rl ` ~ N •'j k z o.a RW, W W a s a0-4 v, et) Z A > 4,—,� , 3 y w hil W W v cn o Ln A _ o 'r) W � � � P4 0 0 � � o ` C) 1/�, � ON G1 E" "i 0 v p 2 w W >' 4-4 4 �. O oCU z 0 z o op- Gw° F' oo Cn z Q V a . ouC /U o W O H QO O •i 2d3 ICI b Q � 2 Z ' 10, zA � - z o0 ov a xa rg - MCI � G1 0�/ U W �• -� �! � � � o 'S 2s `� C/� Fil C4 cn z Z v o +� o Tw o .0 v � � U = r~n W o O z z F � � `n z o C) : W o o U o � :^ � .. A a. ° v H O U w a_ a : U � aaa° w xc m4 "0 _ _ BUILD .I- KIt MENT {� r VIL E OF RYH. OOK DD 938 KING4 ,F4 RYE URA.NY 10573 7 t �. ,. "' APR 18 20�4 \/1LLArF -F RYE BROOK APPLICATION FOR PERMIT TO INSTALL AND/Q114fik PAFt_FMENT I HEATING, VENTILATION AND/OR AIR CONDITIONING EO>Ui MENT I=OR OFFICE. USE ONL ': PERMIT #: �LP_D'/7 Approval Date: LA Permit Fce: S a Approval Signature: 14V Other: Disapproved: (Gees are non-refundable) - DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED RY THE INSPFC'TOR. THE ADMINISTRATIVE: FEE FOR WORT{ PROGRESSED OR COMPI f:TED WITHOUT A PERMIT IS 12%OF TIIF. TOTAL COST OF CONSTRUCTION WITH A MTNIMUM FFF OF 5754 on REUUIRENIFNTS FOR RELEASE OF PERMIT& CERTIFICATE OF CONIPLIANCF' 1. Properly completed & Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook muse be listed as certificate holder)&Workers Compensation Insurance on a NYS Board form (Form#C105.2 or Form#U26.3 I or NY Statc Workers Cutnpensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL = S I00.00/unit• COMMERCIAL =S350.00/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. R. Plumbing/Gas work requires a separate Plumbing Permit & Plumbing Inspection. *t*AlfA#AkA****#A*#A*A+k*A*AArFkAA**tkf**tk*#**A*ir*A*A*1k*A*itAAAAA#AARAAAAAAfAAiA#****##t#*#t*tttttfc*u Application dated, —� � is hereby made to the Building Inspector of the Village of Rye Brook for a pennit for the installation and or removal of the HVAC equipment as listed bclo«•. 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 Ian S, codes,rules and regulations. I. Address: I a r L l� • SBL: ��`� _� Zonc:� �40 2. Property Owner: Kan1 r Address: ci[t[ l i �t Phone#: 4q - Ij cell #: email: dd 3. Contractor: ri7 Address: to20 F 4C, 1 , �C.0 Phone#: C1 Iq - U Cell #: email: wny&kkl t 4. Scope of Work: New Installation ( )• Replacement(v Removal( )• Other( ): on 1 5. List Equipment: U 6. Location of Equipment: e fri' 7. Method of Installation/Remo%al (list all iyuipntent ne,-J A to Perform job): t I Ia>►tr STATE OF NEW YORK, COUNTY OF WESTCH STER ) as: being duly sworn,deposes and states that he/she s the a tprint name of individual�ignin�as the applicanr) i pplcant above named, and further states that(s)hc is the Heating. Ventilation and/or Air Conditioning Contractor Far the legal owner and is duly authorized to make and file this application. y That all statements contained herein are true to the best of his/her knowledge and belief,and that an conducted at the above captioned property will be in contirrTnancc with the details as set forth y wOik performed,or use and in any accompanying approved plans and specifications, as well as in accordance with tth and Contained in this a ; Prevention R Building Cade.the Code or the Village of Stye Brook and all other a licablc(awsew York State Uniform plicatiott pp ordinances and regulations. Fire gulations. Sworn to before me this �,! Sworn to before me thi �� -- day of , 2(,2H s v — day of 20 Signature of Property Owner Signature of Applicant Prin acne of Propr caner Pttint me of Applican otary Public Notary Public Frances Sena Frances Sena NOTARY PlBl.1C.STATE OF NEW YORK v01-%RY PLBUC.STATE OF NEW YORX Rgisaation No.ME6313883 Qualified in Westchester County Re iied in N s he to Cotia3 Commission Expires 101'_'7n Qualified in W'esteluater Cooaty Commission E.cpi es lof_7P0� "[-his application must be properly completed it] its entirety and must include the notarized sigenature(s)of� the legal owncr(s) 0f'thc subject property, and the applicant of record in the spaces provided. Any C application not properly completed in its entirety and/or not properly signed shall he deemed null and voi and will he relurned to (lie applicant. . _ _ C oLn o w = N N ■ R.� N N _ W o tn to AC U W s Q a N O O i 00 M Ci A C W► ■ N as CL 0r+a M� cn u Z O z ■ o W �, �' 1� ,'� z � � w 8 � �i ■ ` l O � ♦� F""� a, W W � A „ 00 .. V w 7 z a O o $ � o o � n zuz z v w z ad c. A V 00 Ln ►.-� M O �O/ w w 5 � W0-4 F F x W O cg W i OG 04 ' w O O x W tZ p w z u � a N A a z a 02 : J BR BUIL RIMENT VIL>CcS,A, E OF RYE ROOK 938 KINEET RYE B ,NY 10573 � or N1A.Y 2 0 . ELECTRICAL PERMIT APPLICATI N✓lu_AG�Z OF RYE BROOK Westchester County Master Electricians Licen 1J1L'` [J . DEPARTMENT FOR OFFICE USE ONLY - wc�) EP#: to Approval Date: 'a ��a Permit Fee: $ (� d- Approval Signature: Other: Application dated, .5 I p�`4 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. 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. 1.Address: P E5 e qA©U.J,(��( �—1?1 A SBL: l 35,a S- - Zone ,Qo 2.Property Owner. I V3 K Address:1P 5k�d"Ry & Phone#: Cell#:t'p Ae i �q-��9 ( email: �2fY L� � t S w car P2 3.Master Electrician/Licensed Installer: Address: Y+f C 1,-§A try 1 ?Z Lic.#: Phone#: - D Cell#:9 la'1(ec)-Lk O910 email: Company Name: L 132Oo. Cl�—try c it1C= Address:145 4.Proposed Electrical Work/Fixture Count: c() -r )ki r 5.31 Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 3;_Jf ��- A`-_ being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the nd1 E Ltr� i at_\ for the legal owner and is duly authorized to make and file this application. (Mister Electrician/Licensed Installer) The undersigned further states 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. _OnthSworn to before me this ' Sworn to before me this � " day of_AoLq 20 a day of ,20 Si ature of Property Owner a of Applicant Print ame of o er Prin Nam of Appli nt f NDVAeft o Public o Public Nott y Pub .Stdq of Now Yolk Nohry Pd*.Stdo of NewYalk RegiwaWn No.01014819030 iAgWidon No.01014819030 Oudfied in Westchester OUMN in Westchester Coin Cmnntission Expires 07/311� counmlon Expires 07/31/20_ 3/32023 STATEWIDE • Service With hitegrity 1:1 Main Street,Fishkill, NY 12524 1 email:• • SWIS JOB APPLICATION845.202.7224914.219.1062 • • • O`f.c(,Use Elect.Permit# Date Ut,rty ID# Final Certificate# City/Village? Zip Township County + Address- Cross Street Section Blo �] of Owner Name/Address Of different than above) { 1 F Contact Number 19 Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 FL ❑Garage ❑Attic Outside Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 13P I #Meters I#Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information For r ct_o won C(,,di n Uri > 3 5 MAY 2 0 2024 VILLAGE OF RYrE BROOK BUILDING DEPARTMIENT This application is valid for one(1)year from the date received by S1MS.This application is intended to cover the above listed items to be inspected,if at any time 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. Inspector Date Finalized Inspector# Company Name Date Signature _#.� Address 1 ( City/State ., E Zip Code i License# Phone# ! , it L��— LIT D DState Wide Inspection Services 1080 Main Street MAY 2 4 2024 Fishkill, NY 12524 a 845 2-7224 Phone STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK 914-219-1062 Fax BUILDING DEPARTMENT Email: officeCcbswisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: La Bella Electric Inc. Matthew& Randi Bergtraum Jerry La Bella 25 Meadowlark Road 145 South Main Street Rye Brook, NY 10573 Port Chester, NY 10573 Located at: 25 Meadowlark Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-101 135.28 1 1 Certificate Number: 2024-3313 Building Permit Number: MP 24-052 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: 25 Meadowlark Road, Rye Brook, NY 10573 The Basement and Exterior3 was 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 23rd day of May 2024. Name Quantity Rating Circuit Type HVAC System 01 Officer: Frank 1. 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. Amwl " 4A7A3036-SUB-103.00 TAG: • ' • 3 Ton Split System NOTE:All dimensions are in mm/inches. Cooling — 1 Phase B 4A7A3036A Product Specifications OUTDOOR UNIT002 4A7A3036A1000A POWER CON NS.—V/PH/HZ® 208/230/1/60 MIN.BRCH.CIR.AMPACITY 20 BR.CIR. MAX.(AMPS) 35 PROT. RTG.} MIN.(AMPS) 30 SERVICE PANEL COMPRESSOR DURATIONT" - SCROLL NO.USED-NO.SPEEDS 1 -1 ELECTRICAL AND REFRIGERANT VOLTS/PH/HZ 208/230/1/60 COMPONENT CLEARANCES PER PREVAILING CODES. R.L.AMPS 0-L.R.AMPS 15.4-83 FACTORY INSTALLED START COMPONENTS OB NO INSULATION/SOUND BLANKET NO COMPRESSOR HEAT NO OUTDOOR FAN PROPELLER TOP DISCHARGE AREA SHOULD BE DIA.(IN.)-NO.USED 23-1 ABOVE UNRESUNITTEUNETi ��RSxOULD AT ABE PLACEDST 1524 550EROOF TYPE DRIVE-NO.SPEEDS DIRECT- 1 RUN-OFF HATER DOES XOF POUR DIREC TLT ON UNIT, AND SHOULD BE AT LEAST 305 (12-) FROM WALL AND CFM @ 0.0 IN.W.G.® 3160 ALL SURROUNDING SHRUBBERY ON Two SIDES. NO. MOTORS-HP 1 -1/8 OTHER TWO SIDES UNRESTRICTED. — MOTOR SPEED R.P.M. 825 VOLTS/PH/HZ 200/230/1/60 F.L.AMPS 0.7 OUTDOOR COIL—TYPE SPINE FIN TIA ROWS- F.P.I. 1 -24 FACE AREA(SQ.FT.) 21.25 K TUBE SIZE(IN.) 3/8 ELECTRICAL REFRIGERANT SERVICE PANEL LBS.—R-410(O.D.UNIT)® 6 LBS.,7 OZ. FACTORY SUPPLIED YES 25 (11 LINE SIZE-IN.O.D.GAS© 3/4 22.2 (T/B) DIA. HOLE LINE SIZE-IN.O.D.LIQ.© 3/8 LOW VOLTAGE A CHARGING SPECIFICATION 28.R u-1/B) DIA. N.O. SUBCOOLING 10°F ROLE w 22.2 (T/e) DIA. EFOA ELECTAICAO BOTTOM LI DIMENSIONS H X W X D POWER SUPPLY CRATED (IN.) 42 X 30.1 x 33 LIOUID LINE SERVICE VALVE, 'E' I.D. FEMALE WEIGHT BRAZE CONNECTION H WITH I/4 SAE FLARE F SHIPPING (LBS.) 230 PRESSURE TAP FITTINGS. NET(LBS.) 202 FIG. I O Certified in accordance with the Air-Source Unitary Air-Conditioner Equipment certification program, .0. FOR ALTERNATE which is based on ARI standard 210/240. G ELECTRICAL ROUTING (D Rated in accordance with ARI standard 270. O Calculated in accordance with Nat].Elec.Codes.Use only HACR circuit breakers or fuses. AS LINE I/4 TURN BALL SERVICE VALVE, -0- (D Standard Air—Dry Coil—Outdoor I.D. FEMALE BRAZED CONNECTION WITH 1/4 SAE (D This value approximate.For more precise value see unit nameplate. FLARE PRESSURE TAP F I TT I MG. © Max.linear length 60 ft.;Max.lift-Suction 60 ft.;Max lift-Liquid Et]ft. For greater length consult refrigerant piping software Pub.No.32-3312-0' ('denotes latest revision). O This value shown for compressor RLA on the unit nameplate and on this specification sheet is used to compute minimum branch circuit ampacity and max.fuse size.The value shown is the From Dwg.21 D152862 Rev.18 branch circuit selection current. OO No means no start components.Yes means quick start kit components.PTC means positive temperature coefficient starter. MODELS IBASEIFIG.1 A I B I C D I E I F I G H J K 14A7A3036AI 3 1 1 933 36-3/4 829 32-5/8 756 29-3/4 3/4 1 3/8 1143(5-5/8) 92 3-5/8 210 8-1/4 79 3-1/8 508 20 A-weighted Sound Power Level [dB(A)] SOUND POWER MODEL LEVEL[CIB(A)] A-WEIGHTED FULL OCTAVE SOUND POWER LEVEL dB-[dB(A)] 63 125 250 500 1000 1 2000 4000 8000 4A7A3036A1 76 45.5 58.7 63.1 69.7 70 1 68.1 59 49.8 Note:Tested in accordance with ARI Standard 270.95.(Not listed with ARI) @ 2006 American Standard Inc. All Rights Reserved Mechanical Specification Options General Condenser Coil The 4A7A3 is fully charged from the The outdoor coil provides low airflow factory for up to 15 feet of piping.This resistance and efficient heat transfer. unit is designed to operate at outdoor The coil is protected on all four sides by ambient temperatures as high as 115°F. louvered panels and has a 10 year Cooling capacities are matched with a limited warranty. wide selection of air handlers and Low Ambient Cooling furnace coils that are A.R.I.certified.The As manufactured,this unit has a cooling unit is UL listed.Exterior is designed for capability to 55°F.The addition of an outdoor application. evaporator defrost control permits Casing operation to 40° F.The addition of an Unit casing is constructed of heavy evaporator defrost control with TXV gauge, G90 galvanized steel and painted permits low ambient cooling to 30' F. with a weather-resistant powder paint Accessories on all louvers, panels, prepaint on all Thermostats—Cooling only and other panels.Corrosion and weather- heat/cooling (manual and automatic� proof CMBP-G30 DuraTuff base. changeover).Sub-base to match thermo- Refrigerant Controls stat and locking thermostat cover. Refrigeration system controls include Evaporator Defrost Control—See Low condenser fan, compressor contactor Ambient Cooling. and high pressure switch.High and low pressure controls are inherent to the compressor.A factory installed liquid line drier is standard. Compressor The ClimatufP compressor features a 10 year limited warranty, internal over temperature and pressure protection and total dipped hermetic motor.Other features include:roto lock suction and discharge refrigerant connections, centrifugal oil pump and low vibration and noise. �. UL us ARI Standard 210/240 UHP Akw " 8/06 American Standard Inc. 6200T—pHighway American Standard has a policy of continuous product and product data improvement and it reserves the right Tyler,Texas75711 to change design and specifications without notice. TRANS` Aluminum Cased Heat Pump / Cooling Coils 1 -1 /2 - 5 Ton 4TXC-Series Coils Heat Pump /Cooling Coils for R-410A 22-1960-1 B-EN TA WE" Aluminum Heat Pump Coil Nomenclature 4 T X C A 0 0 2 D S 3 H C A A Refrigerant Type 4 - R410A Product Family T-Premium (Heat Pump or Convertible Coil) Coil Design X - Direct Expansion Evaporator Coil Product Family C - Cased A Coil A- Uncased A Coil F - Cased Horizontal Flat Coil Coil Width (Cased/Uncased) A- 14.5"/ 13.3" B - 17.5"/ 16.3" C - 21.0"/ 19.8" D - 24.5"/23.3" H - 10.5" Refrigerant Line Coupling 0 - Brazed Model Number Distinguisher Major Design Change Efficiency C - Standard S - Hi Efficiency Refrigerant Control 3 - TXV - Non-Bleed Coil Circuitry H - Heat Pump Airflow Configuration A- Upflow Only U - Upflow/ Downflow H - Horizontal Only C - Convertible - Upflow, Downflow, Left or Right Airflow Minor Design Change Unit Parts Identifier 22-1960-1B-EN TRAKF General Data PRODUCT SPECIFICATIONS01 4TXC-DS --- HIGH EFFICIENCY STAGED SPLIT SYSTEM HEAT PUMP/ COOLING COMFORTrm COILS -- CASED UPFLOW/ DOWNFLOW/ HORIZONTAL 4TXCA002DS3HCB 4TXCB003DS3HCB 4TXCA032DS3HCB 4TXCB004DS3HCB 4TXCC005DS3HCB INDOOR COIL--Type PLATE FIN PLATE FIN PLATE FIN PLATE FIN PLATE FIN Cooling Capacity(Tons) 1.5-2.0 1.5-2.5 2.5-3.0 3.0-3.5 3.0-3.5 Rows/F.P.I. 2/20 3/14 2/20 3/12 3/12 Face Area(sq.ft.) 3.0 3.5 4.5 5.0 5.0 Tube Size 3/8 3/8 3/8 3/8 3/8 Refrigerant Control Non-Bleed TXV Non-Bleed TXV Non-Bleed TXV Non-Bleed TXV Non-Bleed TXV Internal check valve Yes Yes Yes Yes Yes Drain Conn.Size(in.) 3/4 NPT 3/4 NPT 3/4 NPT 3/4 NPT 3/4 NPT Duct Connections See Outline Drawing See Outline Drawing See Outline Drawing See Outline Drawing See Outline Drawing REFRIGERANT R-410A R-410A R-410A R-410A R-410A CONNECTIONS BRAZED BRAZED BRAZED BRAZED BRAZED Line Size Gas(in.) 3/4 3/4 3/4 7/8 7/8 Line Size Liquid(in.) 3/8 3/8 3/8 3/8 3/8 DIMENSIONS(in.) H X W X D H X W X D H X W X D H X W X D H X W X D Crated(H x W x D) 21-9/16 x 18-1/2 x 27-1/2 21-9/16 x 21-1/2 x 27-1/2 26-9/16 x 18-1/2 x 27-1/2 26-9/16 x 21-1/2 x 27-1/2 26-9/16 x 25 x 27-1/2 Uncrated 17-1/2 x 14-1/2 x 21-1/2 17-1/2 x 17-1/2 x 21-1/2 22-1/2 x 14-1/2 x 21-1/2 22-1/2 x 17-1/2 x 21-1/2 22-1/2 x 21 x 21-1/2 WEIGHT(Ibs) 42/34 50/42 49/41 58/50 60/52 Shipping--Net 4TXCB006DS3HCB 4TXCC007DS3HCB 4TXCD008DS3HCB 4TXCC009DS3HCB 4TXCD010DS3HCB INDOOR COIL--Type PLATE FIN PLATE FIN PLATE FIN PLATE FIN PLATE FIN Cooling Capacity(Tons) 3.5-4.0 3.5-4.0 3.5-5.0 3.5-5.0 3.5-5.0 Rows/F.P.I. 3/14 3/14 3/14 3/16 3/16 Face Area(sq.ft.) 5.5 6.0 6.0 7.0 7.0 Tube Size 3/8 3/8 3/8 3/8 3/8 Refrigerant Control Non-Bleed TXV Non-Bleed TXV Non-Bleed TXV Non-Bleed TXV Non-Bleed TXV Internal check valve Yes Yes Yes Yes Yes Drain Conn.Size(in.) 3/4 NPT 3/4 NPT 3/4 NPT 3/4 NPT 3/4 NPT Duct Connections See Outline Drawing See Outline Drawing See Outline Drawing See Outline Drawing See Outline Drawing REFRIGERANT R-410A R-410A R-410A R-410A R-410A CONNECTIONS BRAZED BRAZED BRAZED BRAZED BRAZED Line Size Gas(in.) 7/8 7/8 7/8 7/8 7/8 Line Size Liquid(in.) 3/8 3/8 3/8 3/8 3/8 DIMENSIONS(in.) H X W X D H X W X D H X W X D H X W X D H X W X D Crated(H x W x D) 30-13/16 x 21-1/2 x 27-1/2 30-13/16 x 25 x 27-1/2 30-5/8 x 28-1/2 x 27-1/2 34-3/4 x 25 x 27-1/2 34-3/4 x 28-1/2 x 27-1/2 U ncrated 26-3/4 x 17-1/2 x 21-1/2 26-3/4 x 21 x 21-1/2 26-3/4 x 24-1/2 x 21-1/2 30-3/4 x 21 x 21-1/2 30-3/4 x 24-1/2 x 21-1/2 WEIGHT(Ibs) 63/55 69/61 72/64 78/70 81 /73 Shipping--Net [11 These indoor coils are A.H.R.I.certified with various split system air conditioners and heat pumps(A.H.R.I.Standard 210/240). Refer to the Split System Outdoor product information site or www.ahrinet.org 22-1960-1 B-EN 3 TRANE" Performance Data PRESSURE DROP CHARACTERISTICS FOR COOLING AND HEAT PUMP COILS AIRFLOW(CFM)VS. PRESSURE DROP ACROSS WET COIL PRESSURE DROP(INCHES OF WATER COLUMN) Model 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 4TXCA002DS3HCB 225 340 430 510 585 650 715 775 4TXCA032DS3HCB 375 570 725 860 985 1100 1200 1305 4TXCB003DS3HCB 350 525 665 790 900 1000 1095 1180 4TXCB004DS3HCB 440 655 825 970 1100 1220 1330 1435 4TXC8006DS3HCB 430 640 815 965 1095 1220 1335 1445 4TXCC005DS3HCB 520 770 970 1145 1300 1440 1570 1695 4TXCC007DS3HCB 505 760 965 1140 1300 1445 1580 1710 4TXCC009DS3HCB 490 740 940 1120 1280 1425 1565 1695 4TXC D008DS3HCB 580 870 1100 1300 1485 1650 1805 1950 4TXC D010DS3HCB 555 835 1065 1265 1445 1615 1770 1915 R-22 CONVERSION NON-BLEED TXV KITS Coil R-22 TXV Kit 4TXCA002DS3HCB 4TXCA032DS3HCB 4TXCB003DS3HCB 2AYTXVH3H1836A 4TXCB004DS3HCB 4TXCC005DS3HCB 4TXCB006DS3HCB 4TXCC007DS3HCB 2AYTXVH3H4248A 4TXCD008DS3HCB 4TXCC009DS3HCB 2AYTXVH3H6060A 4TXCD010DS3HCB 4 22-1960-1 B-EN 0 -- Q o � Q ` ao Q \ Cl) --- --- M � � � ip O 0 i � � M N7 N U U m O M N O X U U- S S O - C`7 O QQ a W U O o m ¢ ao ao Q x U ^ N O N- O G M + w m Cl) 0 0 1v Cl) C) U) O Q �t () m O O 0 Ct X U ' Q C7 °0 g o oo = CD Cl) CD - = U) _ 0 U �0 0 0 X o ¢ X U a ~ S Cl) Ur) m ; � Q S O a — - Cl) Q = O v� N () O O � X O F— Q Uw X () Q N OO C3 5a = U= m m a. �E g LU I 0 ¢ N 0 0////) 0 X U Q Q M N CM - - - - - °0 - R �. a.. C L O O3— � K 3 ¢ ¢ ; w w d a 22-1960.1 B-EN MAKE* Trane-by Trane Technologies (NYSE:TT), a global climate innovator-creates comfortable, energy efficient indoor environments for commercial and residential applications. For more information, please visit trane.com or tranetechnologies.com. C( Ull� C us c i�- us LISTED Intertek Trane has a policy of continuous data improvement and it reserves the right to change design and specifications without notice.We are committed to using environmentally conscious print practices. 22-1960-1 B-EN 12 Apr 2021 Supersedes 22-1960-1 A-EN(October 2020) ©2021 Trane 444561-LTG-H-1016 ® DESCRIPTION These compact units employ induced combustion, reliable hot surface ignition and high heat transfer aluminized tubular heat exchangers. The units are factory shipped for installation in HEAT/N G A/R C O N D/T/O N/N G upflow or horizontal applications and may be converted for downflow applications. These furnaces are designed for residential installation in a basement, closet, alcove, attic, recreation room or garage and TECHNICAL GUIDE are also ideal for commercial applications.All units are factory assembled, wired and tested to assure safe dependable and 96% AFUE TWO STAGE RESIDENTIAL economical installation and operation. GAS FURNACES MULTI-POSITION These units are Category IV, National Fuel Gas Code and may be vented either through side wall or roof applications using MODELS: TM9T approved plastic combustion air and vent piping. Approved plastic combustion air and vent piping include Selkirk Polyflue, NATURAL GAS Duravent Polypro, & Centrotherm Innoflue polypropylene vent- 60 -120 MBH INPUT ing systems. FEATURES • Two stage heating operation includes two stage gas valve, two stage inducer operation and 4 speed,direct drive PSC motor blower operation.Adjustable delay timer allows two stage operation with a single stage thermostat. • Easily applied in upflow,horizontal left or right,or downflow installation with minimal conversion necessary. • Compact, easy to install, ideal height 33"tall cabinet. • Blower-off delay for cooling SEER improvement. • Easy access to controls to connect power/control wiring. • Built-in, high level self diagnostics with fault code display. - \ Low unit amp requirement for easy replacement applica- tion. polyflue' All models are convertible to use propane(LP)gas. Electronic Hot Surface Ignition saves fuel cost with increased dependability and reliability. • 100%shut off main gas valve for extra safety. • 24V,40 VA control transformer and blower relay supplied ® Y for add-on cooling. Hi-tech tubular aluminized steel primary heat exchanger QUALITY =i )) AMERICANwith GWI exchanger hangerr for outstanding efficiency. ainless steel tube/aluminum secondary heat DESIGNED,ENGINEERED■ASSEMBLED IN THE USA ISo 9001 Solid removable bottom panel allows easy conversion. - Certified Quality Airflow leakage less than 1%of nominal airflow at duct per- Management System formance testing conditions. 00'. • No knockouts to deal with, making installation easier. Due to continuous product improvement,specifications Movable duct connector flanges for application flexibility. are subject to change without notice. Quiet inducer operation. Visit us on the web at Inducer rotates for easy conversion of venting options. www.upgnet.com and www.luxaire.com Fully supported blower assembly for easy access and Additional rating information can be found at removal of blower. www.ahridirecto .Ora External air filters used for maximum flexibility in meeting customers IAQ needs. WARRANTY SUMMARY Insulated blower compartment for thermal and acoustic A 20-year limited warranty on heat exchangers in residential performance. applications. 1/4 turn knobs provided for easy independent door A 10-year warranty on the heat exchanger in commercial removal. applications. Internal condensate trap design(patent pending)provides Standard 5-year limited Parts warranty. condensate management options and is self priming to prevent nuisance problems. Extended lifetime heat exchanger and 10-year limited parts warranty when product is registered online within Protection included from air intake, exhaust vent or con- 90 days of purchase for replacement or closing for new dentate blockage. home construction. Venting applications maybe installed as either 2 pipe See Limited Warranty certificate in Users Information Manual for details. sealed combustion or single pipe vent using Indoor com- bustion air. FOR DISTRIBUTION USE ONLY-NOT TO BE USED AT POINT OF RETAIL SALE 444561-LTG-H-1016 LEFT SIDE FRONT RIGHT SIDE Combustion Air Inlet Combustion Air Inlet Condensate Drain 10 Gas Pipe (Downflow) —11-�o Entry Gas Pipe Condensate Drain Entry or(Downflow) Vent Outlet Electrical Electrical Entry Entry Vent Outlet Condensate CD Drain ® ® 33 Condensate 23 r ® ® Drain r Thermostat C-) n � B Wiring Thermostat I' III Wiring Optional Return Air Cutout(Either side) 14 L U U U 1 L J J 28.5 0 9 �� 1 5 .5" 56 23.8" 0 3"f— Vent T Outlet T B Combustion B Air Inlet C 1 56" t.56" 4 24.25" 20" ►� SUPPLY END RETURN END Cabinet& Duct Dimensions Inches Cabinet Dimensions Approximate BTUH (kW) Nominal Cabinet (Inches) Operating Weights Input CFM (m3/min) Size A B C Lbs TM9T060B121VP11 1200 B 17 112 16 3/8 13 1/4 122 TM9T080B12lVP11 1200 B 17 1/2 16 3/8 14 3/4 126 TM9T080C16MP11 1600 C 21 19 7/8 16 1/2 136 TM9T100C16MP11 1600 C 21 19 7/8 18 1/4 142 TM9T100C20MP11 2000 C 21 19 7/8 18 1/4 145 TM9T120D20MP11 2000 D 24 1/2 23 3/8 21 3/4 156 Ratings & Physical/Electrical Data Input Output Total AFUE High Fire Low Fire Model High/Low High/Low Unit Air Temp.Rise Air Temp.Rise MBH MBH Amps % °F °F TM9T060B121VP11 60/39 58/37 10 96 35-65 35-65 TM9T08013121VIP11 80/52 77/50 10 96 45-75 20-50 TM9T080C161VlP11 80/52 77/50 11.5 96 45-75 25-55 TM9T100C16MP11 100/65 96/62 11.5 96 35-65 35-65 TM9T100C20MP11 100/65 96/62 17 96 45-75 20-50 TM9T120D20MP11 120/78 115/75 17 96 45-75 35-65 Max.Outlet Blower Blower Max. Min.Wire Size Model Air Temp. Size Over-current (awg)@ 75 ft. °F HP Amps In. Protect One Way TM9T060B12MP11 190 0.50 7 11 x 8 15 14 TM9T080B12MP11 190 0.50 7 11 x 8 15 14 TM9T080C16MP11 190 0.75 8.8 11 x 10 15 14 TM9T100C16IVP11 190 0.75 8.8 11 x 10 15 14 TM9T100C20MP11 190 1.00 14.5 11 x 11 20 12 TM9T120D20MP11 190 1.00 14.5 11 x 11 20 12 Annual Fuel Utilization Efficiency(AFUE)numbers are determined in accordance with DOE Test procedures. Wire size and over current protection must comply with the National Electrical Code(NFPA-70-latest edition)and all local codes. The furnace shall be installed so that the electrical components are protected from water. 2 Johnson Controls Unitary Products 444561-LTG-H-1016 FILTER PERFORMANCE Concentric Vent Termination -For use through rooftop, side- The airflow, capacity data published in the "Blower Perfor- wall.Allows combustion air to enter and exhaust to exit through mance"table shown represents blower performance WITHOUT single common hole. Eliminates unsightly elbows for a cleaner filters. installation. All applications of these furnaces require the use of field S1-1CT0302(2")&S1-lCT0302-636(2") installed air filters. All filter media and mounting hardware or S1-1CT0303(3")&S1-lCT0303-636(3") provisions must be field installed external to the furnace cabi- Sidewall Vent Termination Kit-For use on sidewall, two-pipe net. DO NOT attempt to install any filters inside the furnace, installations only. Provide a more attractive termination for loca- tions where the terminal is visible on the side of the home. S1-1HT0901 (3") S1-1HT0902(2") Single side return above 1800 CFM is approved as long as the filter velocity does not exceed filter manufacturer's rec- Condensate Neutralizer Kit -Neutralizer cartridge has a 1/2" ommendation and a transition is used to allow use on a plastic tube fittings for installation in the drain line. Calcium car- 20x25 filter. bonate refill media is also available from the Source 1 Parts (p/ n 026-30228-000). Recommended Filter Sizes(High velocity 600 FPM) S1-1NK0301 CFM Cabinet Side Bottom Side Return Filter Racks - The S1-1SR0200 Kit accommo- Size (in) (in) dates a 1", 2"or 4"filter.The S1-1SR0402 Kit accommodates a 1200 B 16 x 25 16 x 25 1"filter only. 1600 C 16 x 25 20 x 25 S1-1 SR0200-All Models 2000 C (2)16 x 25 20 x 25 S1-1 SR0402-All Models 2000 D (2)16 x 25 22 x 25 Bottom Return Filter Racks -The S1-1 BR05* series are gal- l. Air velocity through throwaway type filters may not exceed 300 feet per vanized steel filter racks.The S1-1 BR06*series are pre-painted minute(91.4 mlmin).All velocities over this require the use of high veloc- steel filter racks to match the appearance of the furnace cabi- ityfilters. net. The S1-1BR05* and S1-1BR06* series filter racks accom- 2. Do not exceed 1800 CFM using a single side return and a 16x25 filter.For CFM greater than 1800,you may use two side returns or one side and the modate a 1",2"or 4"filter. bottom or one return with a transition to allow use of a 20x25 fitter. S1-1 BR0514 or S1-1 BR0614-For 14-1/2"Cabinets Unit Clearances to Combustibles S1-1BR0517 or S1-1BR0617-For 17-1/2"cabinets Application Upflow Downflow Horizontal S1-1BR0521 or S1-1BR0621 -For 21"cabinets S1-1BR0524 or S1-1BR0624-For 24-1/2"cabinets Top 1" 0" 0" ble Floor Base Kit -These kits are required to pre- Vent 0" 0" 0" Combusti Rear 0" 0" 0" vent potential overheating situations when the furnaces are installed in downflow applications directly onto combustible Side 0" 0" 1„ flooring material. These kits are also required in any applica- tions where the furnace is installed in a downflow configuration Floor Combustible Combustible' Combustible without an indoor coil and where the combustible floor base kit Closet Yes Yes Yes provides access for combustible airflow. Line Contact No No Yes S1-1CB0514-For 14-1/2"cabinets 1. For combustible floors only when used with special sub-base. S 1-1 CB0517-For 17-1/2"cabinets * -24"clearance in front and 18"on side recommended for service access. S1-1 CB0521 -For 21"Cabinets All furnaces approved for alcove and attic installation. S1-1 CB0524-For 24-1/2"Cabinets ACCESSORIES High Altitude Pressure Switches - For installation where the Propane (LP) Conversion Kit -This accessory conversion kit altitude is less than 5,000 feet, it is not required that the pres- may be used to convert natural gas units for LP operation. sure switch be changed. For altitudes above 5,000 feet,see kits S1-1 NP0347-All Models below. LP Stainless Steel Burner Kit -This accessory conversion kit S1-1PS3308-All Models may be used to convert existing burners to stainless steel burn- Thermostats - Compatible thermostat controls are available ers for LP use only. through accessory sourcing. For optimum performance, these S 1-32926889000-AII LP Models outdoor units are fully compatible with our Luxaire touch screen thermostat with proprietary(patent-pending)hexagon interface. Natural (NAT) Gas Stainless Steel Burner Kit -This acces- For more information, see the thermostat section of the Product sory kit may be used to replace existing burners with stainless Equipment Catalog. steel burners for NAT gas use only. S1-THXU280-All Models S1-32924441000-All NAT gas Models Johnson Controls Unitary Products 3 Blower Performance CFM -Any Position (without filter) Bottom Airflow Data(SCFM) Models Speed Ext.Static Pressure(in.H2O) 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 High 1492 1442 1378 1325 1243 1176 1075 966 849 655 TM9T060B12MP11 Medium High 1236 1201 1161 1139 1082 1011 919 830 715 590 Medium Low 986 950 961 916 872 831 757 703 600 510 Low 824 795 783 744 713 659 624 554 489 389 High 1597 1537 1484 1435 1370 1286 1230 1155 1075 925 TM9T080B12MP11 Medium High 1338 1307 1273 1223 1179 1123 1065 998 928 812 Medium Low 1113 1094 1077 1043 1008 972 1 924 868 1 803 798 Low 937 916 900 877 854 817 775 718 639 560 High 1919 1865 1802 1738 1671 1600 1517 1414 1322 1201 TM9T080C16MP11 Medium High 1532 1533 1513 1499 1465 1416 1352 1283 1198 1084 Medium Low 1232 1313 1291 1280 1250 1209 1207 1148 1055 937 Low 826 821 853 858 838 817 794 776 760 711 High 1909 1880 1823 1776 1706 1637 1562 1474 1375 1252 TM9T100C16MP11 Medium High 1465 1463 1469 1485 1477 1416 1 1386 1324 1250 1 1114 Medium 1190 1222 1216 1215 1224 1189 1158 1145 1087 996 Low 787 834 819 836 819 810 790 761 690 707 High 2284 2205 2114 2021 1934 1848 1752 1653 1505 1397 TM9T100C20M P11 Medium High 1967 1905 1824 1763 1712 1628 1551 1473 1379 1213 Medium Low 1610 1563 1513 1480 1430 1367 1319 1261 1101 1012 Low 1326 1304 1267 1232 1183 1143 1080 1003 871 798 High 2341 2245 2153 2072 1977 1876 1769 1642 1506 1306 TM9T120D20M P11 Medium High 2002 1952 1878 1823 1739 1657 1563 1458 1322 1185 Medium Low 1615 1579 1533 1473 1430 1368 1282 1186 1091 953 Low 1352 1295 1259 1245 1190 1141 1076 998 938 820 Left Side Airflow Data(SCFM) Models Speed Ext.Static Pressure(in.H2O) 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 High 1470 1406 1361 1309 1241 1155 1060 920 775 628 TM9T060B12MP11 Medium High 1211 1186 1139 1101 1042 980 896 796 681 545 Medium Low 970 957 927 889 853 796 745 660 568 450 Low 793 781 756 724 694 653 1 585 530 469 382 High 1605 1562 1514 1454 1393 1330 1251 1169 1073 940 TM9T080B12M P11 Medium High 1372 1318 1280 1255 1205 1161 1093 1023 943 849 Medium Low 1087 1073 1052 1003 993 953 897 843 775 709 Low 916 896 881 854 831 802 757 708 642 574 High 1956 1907 1846 1778 1717 1647 1573 1483 1353 1209 TM9T080C16MP11 Medium High 1543 1543 1516 1504 1477 1446 1382 1309 1202 1099 Medium Low 1238 1241 1243 1241 1252 1242 1201 1140 1074 967 Low 906 902 903 910 888 866 859 829 795 743 High 1828 1829 1789 1768 1727 1671 1601 1505 1390 1272 TM9T100C16MP11 Medium High 1422 1444 1437 1424 1396 1326 1301 1253 1200 1100 Medium 1224 1229 1243 1234 1219 1193 1168 1135 1088 977 Low 813 819 818 814 783 762 756 732 690 642 High 2391 2286 2165 2079 2004 1934 1839 1692 1560 1366 TM9T100C20MP11 Medium High 1945 1878 1838 1782 1694 1642 1565 1451 1334 1163 Medium Low 1549 1530 1495 1430 1431 1365 1284 1192 1097 1022 Low 1256 1229 1189 1159 1089 1033 1008 950 871 784 High 2343 2253 2167 2071 1979 1881 1785 1668 1473 1351 TM9T120D20M P11 Medium High 1954 1892 1846 1781 1714 1637 1548 1429 1238 1171 Medium Low 1596 1539 1511 1458 1399 1341 1254 1180 942 988 Low 1299 1261 1229 1177 1111 11053 993 937 882 782 1. Airflow expressed in standard cubic feet per minute(CFM). 2. Return air is through side opposite motor(left side). 3. Motor voltage at 115 V. 4. Airflow through across motor side(right side)may be slightly less than the data shown above. Subject to change without notice.Published in U.S.A. 444561-LTG-H-1016 Copyright c 2016 by Johnson Controls, Inc.All rights reserved. Supersedes:444561-LTG-G-0616 York International Corp. 5005 York Drive Norman, OK 73069 > a 0 . Y m o o w > Li bOf = o z W a O a J a Ka N a a€ rasa sF -� o � z a o F z E N r p J m Z of �w t 0 0 � Q o 0 wm� mEOO z Jin ow O +OI W 1 C�— _ s19^ ; of G 62.37' 3 526'3L'30E Q t S -moo AC s,m o g .�_ , let $ b a a -°1 visa `J... � a m � A a a i a b 00.MI 8 c g��"°Y4c� 9� 'yanrna y: c o g W,;6 p a p sQaa aE �bW� W e >> a a d a 2j;�4 a 00oQr m.7o*I% m PU� 6 a �ajis�m��a�a NU-WHEA-03 _ LMARTINEZ ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/11/2023 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 CONTACT Kieran Murphy NAME: HO Acrisure Insurance Partners Services of NY,LLC (A/C,No,Ext):(914)937-1230 jA/C,No):(914)937-1124 90 S. Ridge Street Rye Brook,NY 10573 E-MAIL kmurphy@bncagency.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of New York 13730 INSURED INSURER B: Nu-Way Heating&Air Conditioning Corp. INSURERC: 620 Fayette Avenue INSURER D: Mamaroneck, NY 10543 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 TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTRM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR :S 2290148 9/28/2023 9/28/2024 DAMAGE TO RENTED 500,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 70THER L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F jE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY Ea accident $ X ANY AUTO S 2290148 9/28/2023 9/28/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAR CLAIMS-MADE S 2290148 9/28/2023 9/28/2024 AGGREGATE $ 4,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N TAT TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ WFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook is included as an additional insured when required under written Contract or Agreement.; 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 g Y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NY S I F PO Box 66699,Albany,NY 12206 New York State Insurance Fund I nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A � 133310445 , HAMOND SAFETY MANAGEMENT LLC 6800 JERICHO TURNPIKE SUITE 105W Q 7 SYOSSET NY 11791 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER NU-WAY HEATING 8r AIR CONDITIONING VILLAGE OF RYE BROOK CORPORATION BUILDING DEPARTMENT 620 FAYETTE AVENUE 938 KINGS STREET MAMARONECK NY 10543 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G 1425 911-3 999101 01/01/2024 TO 01/01/2025 02/01/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1425 911-3, 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. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS' COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 STATE INSURANCE FUND 4DIRECTOR, I SURANCE FUND UNDERWRITING VALIDATION NUMBER: 3110095 �HI1 Hill Hill Hill Mill Hill 6 2 0 16 fill 3 2III IIII111111111000 0 0 C 0 000 012 3 IIII�II ��I Form WC-CERT-NOPRINT Version 3(08/29/2019)[WC Policy-14259113] U-263 aS [000000000001236206321[0001-0000142591131r##Glr16317-191[Cert NoP-CERT 11[01-000011