Loading...
HomeMy WebLinkAboutMP24-128IDERMIT # 7—�c�c"l DATE; I:XP; 9 3o 5 SECTION Jam/ BLOCK LOT �S 3 TYPE OF WORK S 74Q c� (o/c �(i t��r?e/4 a JOB LOCATION cD/I CO/ I4 C e CONTRACTOR, NT. COST � 0#c:i� Tf`n # els1,/I 'It 01O�i ,�e►si1e /5U39 FEE � DATE ��cIELIgl l RECORD 1 DATE INSP FOOTING FOUNDATION. FRAMING RGH FRAMING INSULATIONPLUMBING RGH❑ RGH PLUMBING A GAS SPRINKLER / O� ELECTRIC LOW -VOLT ❑❑ ALARM �-- AS BUILT ❑ I _ Z7 . L�e�—�� FINAL 1 per 3III rrl OTHER APPROVALS ARB BOT PB zBA OTHER cc 14 ( I28123 DR 1�t� 4(.Vu.7v 7. t9 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J.Bradbury «-%v-,v.ryebrookny.gov TRUSTEES BUILDING& FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE January 28,2025 Howard Levine&Lori Levine 8 Concord Place Rye Brook,New York 10573 Re: 8 Concord Place, Rye Brook,New York 10573 Parcel ID#: 135.44-1-53 Mechanical Permit#24-128 issued 9/30/2024 for a New Generator This certifies that the 26kw LP gas fired generator,installed under the above captioned permit has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to DR ,R t . 19 V I� G HG VyJ,,, 4 JiCRi Vu�V 'C VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury wwwjyebrookny gov TRUSTEES BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE January 28,2025 Howard Levine&Lori Levine 8 Concord Place Rye Brook,New York 10573 Re: 8 Concord Place,Rye Brook,New York 10573 Parcel ID#: 135.44-1-53 This document certifies that the work done under Mechanical Permit #24-129 issued on 9/30/2024 for the installation of four above-ground propane tanks have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILDING DEPARTMENT For office use only: PERMIT# 2^ 5 VII,I.AGE OF RYE $R60K ISSUED: 938 KING STREET RYE BROOK,NEW YoRK 10573 DATE: 4).939-Ot5f►R FEE: Pnrn vvyG'Vi:ryebrookny.p-oy APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE, AND CERTIFICATION OF FINAL COSTS TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION XttXii#fffi##t##fttXX###Xffi##ftfttXXtffftX#t#X###tXXfX####X#i#t##XXttfft##iXit#ttfffi#tit##XA#tt##ttttt#tXtt#t#f##fX#X##ftfit Address: c7'e) � PLX4.1- e /v 10575 Occupancy/Use: Parcel ID#: / `j . `1� 3 Zone: Owner: L J r, e. Address: Cv I ( ry I /0 P.E./R.A.or Contractor: 04 .14".((//Address: �f (�/ aL*—�DGc.�4, c AO/ 111-'C/f Person in responsible charge: G .,kd'A dddress: 01al •1c%!i� Application is hereby made and sub fitted to the Building Inspector of the Village of Rye Brook or the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/constiuction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: Q� 51 / /f/)e 14 yCiK"�C.� being duly sworn,deposes and says that he/she resides at nt Name of A&icant) (No.an 6-cc ly in r,arC l i e>-cF jjk&(j�/ ,in the County of we 4c,40 S in the State of ,that (Cityfrown/Village) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including al I site improvements, labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may have been donated gratis was:$ 114 Soto, t�" for the construction or alteration of.. 63Q?Ie— y�S7�-e-� �'� CCzxC��P 11 /0 5-7 Deponent further states that he/she has exami ed the approved plans of the structure/work herein referred to for which a Certificate of Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,convened or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shal I have been duly issued by the Building Inspector as per§250-10.A.of the Code of the Village of Rye Brook. Sworn tbe oorpr��e me this -7 Sworn to before me this day of o)(�V aQ.,r ,20 J, day of � � , 20 .S d'k Signature of ProperL7 Of weer Sign• re of Appf t L or " L, < Vl 0GL. [ dl M�rby Owner Print Name o Applicant Notary Public .'.„fir„State of New York Notary Public I�"r4 E6160063 nwestchestercounW.7-1 SHIRLEY T. PRATT LXp1jesJ.%ktu*•y2g,20�.1 Notary Public, State of New York Registration #01 PR6033157 Qualified In Bronx County Commission Expires Nov. 15, '__ QyE aRnuk. o`` tim 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.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : ,?) C'Jtj C_"4- DATE: i PERMIT# �f\Y ISSUED: SECT: . '/ BLOCK: LOT: -�'!J 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 ❑ FINAL ❑ OTHER �E BRC�k• 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 : DATE: PERMIT# ISSUED: 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 Ll /� C J ❑ L.P. GASEl n FUEL TANK ri' CJ ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ... ...._,_ . •ww a � Agyp vp lilt IM 46 t y ... -- - itb� 'ram OAR., �yE BRC�k. '9a2 BUILDING DEPARTMENT ❑11,14LDING 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 : J�J CY 1 l DATE: j PERMIT# ` ! cl— ISSUED: SECT: �l_ 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 f� ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER 6 _ _ th ,tee-. , ! Nid, Ln CL u Ln 0 t at" �E BRC��. O� Zm 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR ElASSISTANT 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 :-C 0,3 c O2 C� ? l _ � DATE: - 1 - Z JZ PERMIT# Z. /S3 ISSUED: '2'-Z-`I SECT:/BLOCK: LOT: ,5J LOCATION: OCCUPANCY: � ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED 2 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 s M q = S 00 = N Pi O o •� � a _ P M 'n „ -o Cn �+C7, ON 1 t14 W U 0. PE 00 = O F-i � O ►� O F � g u � � � a a o _ p w � $ (D O w A N eq v v a • � � � ty 11 O � -W C.: N � o � W O S �i �I aN LYi to ob •: c� w :. F� O Z U Z a C W 0 H V w 0 W w Q o M CN o Of x W a s we 0 a O � � - V .. Ln w /y Z w O O a q o ° 0 04 A H A Q o u U -o' o y MCI k. O '4 a a a a V% O w O V m .� o �. 4 U C7 A z o w o o > ,4 � A w N o � " � � o ti as a cu a a ? x4 � BUILDING DEPARTMENT [E C E d W '� VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 JUL 2 9 2024 (914)939-0668 www.rvebrooknj.L,ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: JUL 1 Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: ? Application Fee: Permit Fees:,4 36o N)e APPLICATION TO INSTALL A PERMANENT STANDBY BACKUP GENERATOR Application dated: 1 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 gerferator in accordance with§2504.1.of the Code of the Village of Rye Brook,as per detailed statement described below. Please note that electrical and plumbing permit applications must he 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. �1 _ 1. Job Address: o✓1 CO l-o/ '" 1 O.�-7 3 2. Parcel ID#: JJ• q " f — ^ 3 Zone: /0 3. N.Y.State Construction Classification: N.Y.State Use Classification: 4. Proposed Generator&Fuel Type(Describe in detail): (Aa K r C �� W ✓d e yu,,ve w�c ��- �161•-6R� 9 I t,c Q[T1J 5. Property Owner: + h e- Address: lb57.3 Phone# g 14 -g3 y - 13 a4 Cell# / - 1,46 ' -7 email: ©f, /ter', _1Z� -+/•C•�h Applicant: I r + C Address: old / U 5 Phone# d -7�,7�- �'743 'Cell �'l' q 593 -A46- W email: � 1'Td (LW) JAAlt-- COW\ Architect or Engineer(if applicable): ✓ , Address: Phone# Cell# email: General Contractor: k. I-. 1) Ole Address: Phone# Cell y1 Y S�f I ��6 � email: '? 4f, Cori, t 611/2024 C 6. Give exact dim si from proposed generator to lot lines: front yard: rear yard: 44 right side yard: ;� left side yard: 7. If building is located on a corner lot,which street does it front on: CR A 8. Will the proposed project disturb 400 sq.ft.or more of land,requiring a Stormwater Management Control Permit from the Village Engineer as per Chapter 217 of the Code of the Village of Rye Brook? Yes: No:_ A _^ 9. Will the proposed project require a Site Plan Review by the Village Planning Board as per Chapter 209 of the Code of the Village of Rye Brook? Yes: No:_ (provide detailed drawings as per Chapter 209) 10. Will the proposed project require a Steep Slopes Permit as per Chapter 213 of the Code of the Village of Rye Brook? Yes: No: (provide a detailed topographical survey) 11. Is the lot or any portion thereof located in a Wetland as per chapter 245 of the Code of the Village of Rye Brook? Yes: No:_X, (provide a detailed survey indicating the Wetland&Buffer Zone) 12. Is the lot or any portion thereof located in a Flood Zone as per the FEMA Flood Insurance Rate Map#36119CO279 dated 9/28/07? Yes: No: 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: Y� (a tree replanting schedule may be required) 14. Does the proposed project involve a Home-Occupation as per Chapter 250-38 of the Code of the Village of Rye Brook? Yes: No:_�,_ If so,indicate: TIER 1: TIER II: TIER III: 15. What is the total estimated cost of construction: $ NO. q'i3p. %D (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 N W YO C,COUNTY OF WESTCHESTER ) as: )o,S Im 4-o' ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of ndividual si,,nin as the applicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the /���,•..t�,l for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to before me this�, el day of , 20 day of 20 1444 Signature of PronerK Owner Signature 04pli ant Lc: LevinC WA ! yl CJ J4 Print Name of Property Owner SOPHIA BIRAGLIA nt,Name fApplicant Notary Public, State of New York A611��A eJ1KA Registration#01 B14775489 Qualified In Westchester CDunlv, Notary P)Afric Commission Expires May 31, c 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 prope6od"t its entirety and/or not properly signed shall be deemed null and void, and will be returned Newry Public,State of New f applicant. Plea" note that application fees are non-refundable. No.DIRI6441398 2 Qualifled In Westchester County Commksion Expires September 26,20 6/1/2024 a = _ a ai a a a rl `T Lr, S' : en W NCAC a; Vi J C _1 e G] a w a ! T ✓ v CL L w M a an O Gi �.. rr x U - a a c W = .. 7 z O N GL, •� G � 0.0 uA M M U C / oft O rti W ; fT A ,1 w M b, V u7 P-4 0�0 = l x � 0.* 'i w z w z .�, � o _. w e a a BUILDING DEPARTMENT VILLAGE OF RYE BROOK p CCEWE 938 KING STREET RYF:BROOK,NY 10573 (914)939-0669 JUL 2 9 2024 www.iyebrookny.�w VILLAGE OF RYE BROOK ELECTRICAL PERMIT APPLICATION1 BUILDING DEPARTMENT Westchester County Master Electricians License Required / FOR OFFICE VS1 ONI.A .1l�''" /- Q)27 _IW I l _Approval Date: _d1L_3 Perinit Fee: S pa _ .approval Si-nature: Other: DO NOT S'I kRT NVORK orCO\S7RL( TIO\ LN 111. % P RNII I ILVS RI.F\ ISSt ED R}' hHE: lit IE.I)I\C: I\SPE_CY'OR. THE ,U)MI\ISTR 1 1'1%'E FETE: EY)R M ORK PROGRI SSI I) OR ( ONIPLI:fF1) \\ I'fHOI 'r 1 yyRNTH IS 120/,, OF THE: TOTAL COST OF CONSTRt C7'1ON N117I1 .k MININII 11 FEE OF S7.50.00 Application dated. ' q 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:T ;,oLe`s�( 16�[_ E- fit K / SBL: 135, 11 � � //�� Done: 2.Property()w•ner: �%t ue S h E. _Address: ��,['�c o'a�/ /t- �f ey Phone;1: � L. - 13a Celt ;: g,/1I�/ ��/�a 17 a 3 email: /0�'� �L �', h�.�' el me-4 1.(4, 3.Llaster EI ft'ician/Licensed Installer: V A 5 1► , j V1 kk L 4e' Address: '< <.3 •-4) Lic.4: L 35 Phone 4: � �'I 3Cc11?: I) � emai1:� t. n .�1, &;6A4N !L Company Name:. P^- Address: 7) e t,e` 6-1 e- V t7 t Ktr� 4.Proposed Electrical Work Fixture Count: Kj M�� rd 5.3"Party Electrical Inspection Agency: i T f OF N WCU �' ,:ing NTY OF WESTCHFST :R ) as: 6tyA" dulN swei n.deposes and states that he she is the applicant above named,and does further state that I s the is the h J l S t; 14Ei�_kt(.-if -fir the legal owner and is duly authorized to make and file this application. The undersigned further states that al I 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 conlimndnce with the details as set fimh 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 bel'ore me this� Sworn to me this _ 3 day of ,2tl -.. __ ray Z _, 20 York Notary � a;- , Signature of c crty Owner Regis" S .t n, scant Lori• Zew)e Commission = } a/ INmc ol,Proerty n I. Print Nam plicpw Nota b' ,Staeof Now Yort Qualified In Westchus,c .., tp{t is No.01R1644f398 / Commission Expires May 31, kl'J t Gaza ouawled in Westchester County Commission Expires September 26,2(> _ STATE WIDE INSPECTION SERVICES, INC. Service Willi litlegritY • ••0 • • SWISJOB APPLICATION •. • Office Use Elect. Permit# /10C _ 9 Date ?/,)G z. Bldg Permit# /A ,77) y / a Sq Ft Plumbing Permit# Final Certificate# City/Village ��[^ Zip (\�", Building Dept. 9 \tcF OFE County Q �� `�lL'S'cC�nPS�e� Address Cross Street Section 1 •l l l Block Lot 5 Owner Name/Address(If different than above) 14'rt LCviNt; _ Contact Number Q1I`l_p13a 13 VA ►�.- ❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic Wutside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch Zrc {LW ZbU SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation 1N5�2\k'\�noN of ZGY-w \%ul,6 �ro�r�C (yrteYC-A`c3V- w%N1n ZOoaVA f aJtot�a�C, �ro�NSCe+r SW�1c[.1r, Fvr Wir\v\,e house. cµeYge�v� bac�- up Po�E'� EC ��� JUL 2 9 2024 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.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. Email Address 114 4O 4i�vyS powe''. Lug Name 16\\-!^�\ %\AULhUt4 (Ur 1p License# 35 Date "� ''�,Z�, Sign�altu�r Address A3 old Chi a V� ,6 City/State \( �\� roc• Zip J1V Company g� ^ Me\ oN yrr VChON or �. Phone#91�1=It�L-'�WH3 9�N-SiSZ-14b � � D E� E ��v/7 State Wide Inspection Services 1080 Main Street DD Fishkill, NY 12524 OCT 17 2024 845 Phone TOW U 914-2194-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: officeC&swisny.com VILLAGE OF RYE BROOK Website: www.swisny.com Service With Integrity F?I III r Il!!n ^c D,'.\C)r !IT BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Bil-Mel Construction Howard & Lori Levine Wasyl Melnychuk Jr. 8 Concord Place 493 Old Chappaqua Road Rye Brook, NY 10573 Briarcliff Manor, NY 10510 Located at: 8 Concord Place, Rye Brook, NY 10573 12590 Section: Block: Lot: Electrical Permit Number: EP 24-193 Certificate Number:2024-7265 Building Permit Number: MP 24-128 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: 8 Concord Place, Rye Brook, NY 10573 The Generator 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 14th day of October 2024. Name Quantity Rating Circuit Type Generator 01 26kW ATS 01 200AM P Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. a 1 i ■ /1 1. ■ � N N � y C ai a G W � U Q � G ✓.' s LLB N a = W s /r 41 fil ' Ln ILI 14 i-.4 1 ev iQ 4 . en O f� W f E 00 fj. f U I v u f = 0-4 Cy OC A N R. ..a W. o 7 _' � .-� A < O F cif F„ z z °' ° c.� � !_ L�" ■ U Jr ? Q a" i 1 V Z F w z ;F Q 04 1 a ECEWED BUILD MENT VIL QI[;Bt')E� OOK SEP ? 6 2024 938 KING ET,IZ;kE B t, ,NY 10573 4�Yob VILLAGE OF RYE BROOK w.r etir-oo ov BUILDING DEPARTMENT Application for Permit to Install Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: Approval Date: SEP 3 0 MR Permit Fee: $ Approval Signature: Other: Disapproved: (fees arc non-refundable) 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• 1. Application Completed by Bonded, Licensed Contractor. 2. Your contractor's valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder) 3. Your contractor's valid proof of workers compensation insurance. (Form#C105.2 or Form#U26.3 /or NY State Workers Compensation Waiver) 4. Fee per Tank: Installation: $185.00 per Tank. 5. Dig Sa;:e y New York#(dial 81 i, 6. Inspection by Building Department for installation. 7. Submit all Manifests & Reports (if applicable, after work has been completed). 8. Certificate of Compliance will be provided when all requirements are fulfilled. Application dated, �� ,is hereby made to the Building Inspector of the Village of Rye Brook for a permit to install a Fuel Tank as herein described.The applicant and property owner,by signing this document agree that the subject fuel tank(s) will be installed in conformance with all applicable Village,County,State&Federal laws,codes,rules and regulations. Indicate Permit Type: Above Ground ()Q • Buried in Ground ( ) 1. Address: 8 Concord Place, Rye Brook NY 10573 SBL:iS5Yy I-S S Zone:le/0 2. Property Owner&Address: Lori Levine 8 Concord Place, Rye Brook NY 10573 Phone#: Cell#: 914-646-3723 email: lorilevine@gmail.eom 3. Contractor&Address: Halstead Quinn Petroleum Phone#:914-666-3200 ext 109 Cell#: email: jerry@hgpetroleum.com 4. Applicant: Halstead Quinn Petroleum Phone#:914-666-3200 ext 109 Cell#: email: jerry@hgpetroleum.com 5. Indicate Fuel Type: Fuel Oil( ) •L.P.Gas�) •Gasoline( )•Other( ): 6. Number and Capacity of each Tank:4-120 gallon above ground propane tanks 7. Exact Location(s)of each Tank: Right Rear (see map) t 6/1/2024 STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: G nrsc I *Jr, ,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 Tank Installation 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 a Sworn to before me this l� day of P m ;20 _ day of 20 a2�' Signature of operty Owner SignaW o ppli t r� Lori' or Levrn e Z1\�b � t Name of Prop Owner Print Name Applicant 1 NQ4Mr$ ic,State of New York bliC Lori Teddeo No.01ME6160063 Notary Public State o/New York Qualified in Westchester County No.n Westchester star C Qualified!n Westchester County Commission Expires January 29,202-:1 Commission Expires December 21,20��_ 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 6/1/2024 Lot 9 Lill ; !� 1 f S 01.18'00" W 93.37' VIU-A E 'RY'_BROG:( Spin Rai Fame 1 QQQ N cc Z at 4 i� �& N . g 14 w .. 10341LIei 6., S0. FT. _ V �b r " PVC y1 AC tea,Level Frame ara" 4b.8 9.0 Pict. Y=fr: s 01.18,W w GM4Z OF Nep A. CONCORD PLACE r -492 4lND Rfc,ard Sp li - Survey of Lot 8 as shown on 'Resubdivision of o 650 Holstead Avenue Portion of Map of Ridge Manor. Section, 2, in the Town Mamaroneck. N. Y. 10543 of Rye, Westchester County. New York" (914) 381-2357 Filed on Marc, 21. 1967 as Mop No. 15272 N.Y.S. Uc. Land Surveyor No. 49240 Scale 1"=2T August 18, 2011 26/3811 "RIDGE MANOR" SECTION Cylinders, Accessories ",■ Worthington DOT/ASME LPG Cylinders (continued) 9 Cylinders DOT Cylinders MFR#_.: VALVE: a = Amw-. C0 QR BB# *� GIT100ASME Tall 100#ASME Less Gauge 100 lbs. White _ 263468 G/T100ASME-G 100#Squat With Gauge 100 lbs. White 269529 GIT100 POL Service 100 lbs. Gray 185223 GIT100M Multivalve 100 lbs. Gray _ 185226 GIT100MW Multivalve 100 lbs. White 194259 G/T200 Multivalve 200lbs. White 185229 G/T200G Multivalve 200lbs. Gray 192637 GIT100M Multivalve 200lbs. Gray 185226 GIT420 Multivalve POL 420 lbs. White 185243 GIT42OG Multivalve POL 420 lbs. Gray 192638 mom° A A '°°m' G/T100ASME G/T100ASME-G...ai�m.,•.•ao-ai .5 m,�uM x� �•°°�R aaI r. 0 !'2 32 �Zmso-°2 a_iz 16 in./407 mm imam M *-I, _.f, M 'YaUDPEA yW.°• V/ 1 sm.oa s yr ss• im.m .a•on ,m•vm ,•s• D SECTION AA ss u00,mmx` °m ao s/• SECTION 0 ASME Cylinders M 2001bs. MFR#. VALVE SIZE COLOR _,WEBB# N GIT200ASME Multivalve 2001bs. White 190984 0 G/T200ASMEG Multivalve 200lbs. Gray 193312 :0 = E G/T420ASME Multivalve POL 420 lbs. White 185244 lm GIT420ASMEG Multivalve POL 420 lbs. Gray 193311 N - c L) I SIZE 100 LBS. 200 LBS. 420 LBS. How to Order a Truckload ` LPG Capacity 23.6 gal. 47.2 gal. 99.1 gal. 89.3 liters 178.5liters 374.9 liters 11 bundles make up a Water Capacity 239.0 lb. 474 lbs. 1000 lb. truckload.Special colors, 108.4 kg. 215.0 kg. 453.6 kg. or plastic mesh protective 420 lbs. Tare Weight 71.0 lb. 158.0 lb. 272.0 lbs. coatings are available upon Description and Sue of 420# 32.2 kg. 71.7 kg. 123.4 kg. request.There is a quantity L.P.G.cylinder Openings Collar Height 5.1 in. 6.6 in. 6.6 in. of 9-420's in a bundle,and A:Safety Relief Valve(1")NPT 130.2 mm 167.6 mm 167.6 mm 16-200's in a bundle.You 8:Fill Valve(314")NPT Footring Dia.o/s 14.5 in. 19.0 in. 22.0 in. must specify DOT or ASME C:NPT Flom Gauge(1")NPT 368.3 mm 482.6 mm 558.8 mm D:Vapor Service Valve(314")NPT style tanks at time of order. Minimum order of 3 bundles Open Collar is considered a partial truckload.No more than 3 100#Cylinders different stops per truckload MFR# DESCRIPTION WEBB# within a 150 mile radius. PiGME350A Multivalve 186562 TO ORDER, CALL: 800.243.9360 • CT: 860.722.2433 • FAX: 800.274.2004 VICTOR`� 93 AD'rvi°gnd FW.W.00C" -- n RELIE:= 1cl ALL H=-!GHT PLUG j 1 4z-:0 wg.A N D U F, AP PR OX 3 ULA,T E AS 0-V E C-�7 - I -'-kj 73 V S S A N.'D S:3 WATER DiAMET-i' N'7-A D 0 V E R A OVEW CA PA-0 TV (OD) TYPELE NGTi ij-I UTE!G HT QUANTff Y rHW1D7 P '] FULL LOAD PE 120 wg, 2411 ' 1 R STACK ElIi 2'-10" 1/7,, 2 /2 260 *250 wg. 30" H a a 71-1011 or 108 1112 21 6 1 14 *320 vj,-. 3011 91-7" a 5 620 .5 9 go 5d 9 1 ' SOO wg, 37 1/2" Hem . 10, 4r -8 ,1 ocr 1 37 30 8 1000 wtclr. 11 Ham . 41-3" if-811 101-"[ .. 800 17 15 6 5 1 1450 wg. 4-S 1/2" Blip. T1 -i - —- 17t-411 1 -9 1 V-7" 2,EM j 2 s--90 W.-, -45' 1/2" 4 Dimensions and specifications shown are approximate, individual vessels may very. Drain plug may not be available in this size. By special request only. Leg spacing+/-2". Leg widths and spacing may vary based on mfg.location. Check with Your salesperson for details, 120,250,320 wg, standard tanks-no holes in lets(one center hole on request). 500 and 1000 vig.standard tanks-2-3/4"ho!:s,15"on shown above. center each leg. 1450 wg.and up as Full lead and stack quantities vary by shipping location. Check with your salesperson for details. General SPeCifications Conforms to the latest edition 011 ASIV11E Rules for Construction of Pressure Vessels, Section Vill, Division 1. Complies with NFPA 58. Rated at 250 psig from -20'F to 125' F. All vessels registered with National Board. All standard vessels UL listed (UL 644-Container Assemblies for LP-Gas). Standard vessels available witij CRN (Canadian Registration Number). Vessels are either Powder coated with TGIC pol irethane ton coat. Yester or primed with liquid epoxy and coated with liquid all vessels are shipped VaCULIV.1 pre-purged to -enable simplified first flif! of the vessel. s M N 4 o O N M M w A4 , c• F F a a x c. a O w t Lei f x h••l � 1 x : ] bG 1 /I � �• ^ C Q � F rl y F Oz � wCIA z O w • � �/ � P�1 s - Tr Tt A � �" as M z � r � r ►� '� f u Z OnoCA M wE O V oc z a Q a 0-4 F C7 A V H z a o ` Vr- 1 h � �'�Butoy NT VK I SEP — 3 2024 938 KIY 10573 K VILLAGE OF RYE BROOBUILDING DEPARTMENT . PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY :l /y/ O� '7`—� PP#: Approval Date: Permit Fee: $ Approval Signature: Disapproved: 1 (fees are non-refundable) 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 PER MI IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 9 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 Pl bin_as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 6 C-01IC-04 elaq, f IC bid /+- SBL: 1 7. 7 / lI J 3 Zone: 2.Proposed Work: �Y) QG�1 G h� �- { ry yv► /�r nc 4 47t)k S. 3.Property Owner: LO Jr i I.x-� I✓1Q- Address: co') C (a - 6L Phone#: J q j I - Cell#: �� - 6,1& 3 7.�,9email: O 6 CA% 4.Master Plumber: U I L Ord 1 Address: /U7 LUaod Svc ✓A-4i I¢,y AXI Lic.#: (&3 Phone#:g 1 Y 7 7 1 -7 9" Cell#: 9"" yY?—/Yy-2 email: /��u 1+��,-vi ft 0� Fn f h•G.�tz, Company Name: pj j ► l�-"tc Address: l a 7 Woo 0 /hK A-44 /41. /ww- I INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Locagon Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 st Floor 2nd Floor 31 Floor 41 Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: I�Un ,� 1 1 rte r1 tj 2n-e y G` ?✓ . (Notarized Signatures Required Next 2 Pages) -I- 6/t/2024 STATE OF NE YORK,COUNTY OF WESTCHESTER ) as: &I L �6 .Gt I 1 ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to b fore le this day of ,20 Ott day of 0�_ Signature of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant Notary lic No Mb ELLEN BALLANTINE GREGORY K RNERA Not blic,State of New York NO ry Public,State of New York Reg#01BA6278291 No.0111I6"1398 Qualified in Westchester County �° QuaWled In Westchester County Commission Expires 31=025 l T!s pp�icTon m�°lst�erprbp completed in its entirety and must include the notarized signature(s)of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/1/2024 • BUILD '__'Di MENT ^Q N7 VIL E OF R OOK 938 KING ET RYE BR ,NY 10573 SEP 3 ZQ24 � 4 -0 ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 3J, L o r► Lt v, At— ,residing at, C o n CO re� 0C.tr_ (Print name) (Address where you live) being duly sworn,deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the propertyy to which this Affidavit of Compliance pertains at; Rye Brook,NY. Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer,and further that there are no roof drains, sump pumps,or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. /O-u /'�,;,,_� (Signature of Property Owner(s)) Lcr� L�v�nP (Print Name of'Property Owner(s)) Sworn to before me this 777 day of rat , 20 2 -! P i GREGORY M.RIVERA Notary Public,State of New York 3 No.01 R16441398 Qualified in Westchester County Commission Expires September 26,20 6/l/2024 GENERAG FillCOPY� GUARDIAN° SERIES 26 kW Residential Standby Generators Air-Cooled Gas Engine _ r Standby Power Rating INCLUDES: 0007290-0,G007291-0(Alum num-Bisque)-26 M 60 Hz • True Power" Electrical Technology • Two-line multilingual digital LCD Evolution" controller (English,'Spanish/French/Portuguese) • 200 amp service rated transfer switch available • Electronic governor `�- • Standard Wi-Fi`�connectivity • System status&maintenance interval LED indicators • Sound attenuated enclosure • Flexible fuel line connector • Natural gas or LP gas operation GENERAC —— • 5 Year limited warranty '— s • Base fascia • Listed and labeled for installation as close as 18 in(457 mm)to a --�' structure.` 'Must be irocatedaway from doors,windows,and fresh air intakes and in U accordance with local codes. c E 1 I us or cLIS EDus �11 11 u� Note:CETL or CUL certification o�nly[appCass to unbundled units and units packagedk' ' with limited circuit switches.Units packaged with the Smart Switch are ETL or UL certitied in the USA only. FEATURES O INNOVATIVE ENGINE DESIGN & RIGOROUS TESTING are at the heart of Gen- O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This erac's success in providing the most reliable generators possible. Generac's G- state-of-the-art power maximizing regulation system is standard on all Generac mod- Force engine lineup offers added peace of mind and reliability for when it's needed els.It provides optimized FAST RESPONSE to changing load conditions and MAXI- the most.The G-Force series engines are purpose built and designed to handle the MUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge rigors of extended run times in high temperatures and extreme operating conditions. loads to the engine.Digital voltage regulation at�1%. O TRUE POWER" ELECTRICAL TECHNOLOGY:Superior harmonics and sine wave O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network form produce less than 5%Total Harmonic Distortion for utility quality power.This provides parts and service know-how for the entire unit,from the engine to the small- allows confident operation of sensitive electronic equipmen:and micro-chip based est electronic component. appliances,such as variable speed HVAC systems. O TEST CRITERIA: O GENERAC TRANSFER SWITCHES: Long life and reliability are synonymous with ✓ PROTOTYPE TESTED NEMA MG1-22 EVALUATION GENERAC POWER SYSTEMS.One reason for this confidence is that the GENERAC ✓ SYSTEM TORSIONAL TESTED MOTOR STARTING ABILITY product line is offered with its own transfer systems and controls for total system compatibility. O MOBILE LINK" CONNECTIVITY:FREE with select Guardian Series Home standby generators, Mobile Link Wi-Fi allows users to monitor generator status from any- where in the world using a smartphone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts. Users can connect an account to an authorized service dealer for last,friendly,and proactive service.With Mobile Link,users are taken care of before the next power outage. GENERAC PROMISE �,•�' GENERAC 26 kW Features and Benefits Engine • Generac G-Force design Maximizes engine"breathing"for increased fuel efficiency.Plateau honed cylinder walls and plasma moly rings help the engine run cooler,reducing oil consumption and resulting in longer engine life. • "Spiny-lok"cast iron cylinder walls Rigid construction and added durability provide long engine life. • Electronic ignition/spark advance These features combine to assure smooth,quick starting every time. • Full pressure lubrication system Pressurized lubrication to all vital bearings means better performance,less maintenance,and longer engine ' life.Now featuring up to a 2 year/200 hour oil change interval. • Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to low oil. • EPA Certified for non-emergency applications Allows unit to be used for demand response applications. • High temperature shutdown Prevents damage due to overheating. Generator • Revolving field Allows fora smaller,light weight unit that operates 25%more efficiently than a revolving armature generator. • Displaced phase excitation Maximizes motor starting capability. • Automatic voltage regulation Regulating output voltage to:L1%prevents damaging voltage spikes. • UL 2200 listed For your safety. Transfer Switch (if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. • NEMA 3R Can be installed inside or outside for maximum flexibility. • Integrated load management technology Capability to manage additional loads for efficient power management. • Remote mounting Mounts near an existing distribution panel for simple,low-cost installation. Evolution" Controls • AUTO/MANUAL/OFF illuminated buttons Selects the operating mode and provides easy,at-a-glance status indication in any condition. • Two-line multilingual LCD Provides homeowners easily visible logs of history,maintenance,and events up to 50 occurrences. • Sealed,raised buttons Smooth,weather-resistant user interface for programming and operations. • Utility voltage sensing Constantly monitors utility voltage,setpoints 65%dropout,80%pick-up,of standard voltage. • Generator voltage sensing Constantly monitors generator voltage to verify the cleanest power delivered to the home. • Utility interrupt delay Prevents nuisance start-ups of the engine,adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer. • Engine warm-up Verities engine is ready to assume the load,setpoint approximately 5 seconds. • Engine cool-down Allows engine to cool prior to shutdown,setpoint approximately 1 minute. • Programmable exercise Operates engine to prevent oil seal drying and damage between power outages by running the generator for 5 minutes every other week. Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. • Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM-style batteries. • Main line circuit breaker Protects generator from overload. • Electronic governor Maintains constant 60 Hz frequency. Unit • SAE weather protective enclosure Sound attenuated enclosures ensure quiet operation and protection against mother nature, withstanding winds up to 150 mph(241 km/h).Hinged key locking root panel for security.Lift-out front for easy access to all routine maintenance items.Electrostatically applied textured epoxy paint for added durability. • Enclosed critical grade muffler Quiet,critical grade muffler is mounted inside the unit to prevent injuries. • Small,compact,attractive Makes for an easy,eye appealing installation,as close as 18 in(457 mm)away from a structure. GENERAC 26 kW Features and Benefits Installation System • 14 in(35.6 cm)flexible fuel line connector Listed ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. • Integral sediment trap Meets IFGC and NFPA 54 installation requirements. Connectivity(Wi-Fi equipped models only) • Ability to view generator status Monitor generator with a smadphone, tablet, or computer at any time via the Mobile Link application for ' complete peace of mind. • Ability to view generator Exercise/Run and Total Hours Review the generator's complete protection profile for exercise hours and total hours. • Ability to view generator maintenance information Provides maintenance information for the specific model generator when scheduled maintenance is due. • Monthly report with previous month's activity Detailed monthly reports provide historical generator information. • Ability to view generator battery information Built in battery diagnostics displaying current state of the battery. • Weather information Provides detailed local ambient weather conditions for generator location. GENERAC� 26 kW Specifications Generator Model G007290-0 G007291-0 (26 kW) Rated maximum continuous power capacity(LP) 26,000 Watts' Rated maximunt continuous power capacity ING) 22.500 Watts, Rated voltage 240 Rated maximum continuous load current—240 volts(LP/NG) 108.3 93.8 ' Total Harmonic Distortion Less than 5% Main line circuit breaker 110 amp Phase 1 Number of rotor poles 2 Rated AC frequency 60 Hz Power fa-tor 1.0 Battery requirement(not included) 12 Volts,Group 26R 540 CCA minimum or Group 35AGM 65O CCA minimum Unt weight(lb/kg) 518 i 235 Dimensions(L x W x H)in/cm 48 x 25 x 29/121.9 x 63.5 x 73.7 Sound output in dB(A)at 23 ft(7 m)with generator operating at normal load'` 67 Sound output in dB(A)at 23 ft(7 m)with generator in Quiet-Test"low-speed exercise mode" 57 Exercise duration 5 min Engine Engine type GENERAC G-Force 1000 Series Number of cylinders 2 Displacement 999 cc Cylinder block Aluminum w/cast iron sleeve Valve arrangement Overhead valve Ignition system Solid-state w/magneto Governor system Electronic Compression ratio 9.5:1 Starer 12 VD% Oil capacity including tiller Approx.1.9 qt/1.8 L Operating rpm 3600 Fuel consumption Natural gas I113/hr(m3/hr)112 Load 188(5.32) Full Load 333(9.43) Liquid propane III(gaVhr)"r] 112 Load 75(2.06)[7.781 Full Load 132(3.63)[13.731 Nu'.e Fuel pipe must be sized for full load.Required fuel pressure to generator fuel inlet at all load ranges-3.5-7 in water column(0.87-1.74 kPa)for NG,10-12 in water column(2.49-2.99 kPa)for LP gas. For BTU content,r iply't'rnr x 2500(LP)or Otr x 1000(NG).For Megajoule content,muli:ply m3/nr x 93.15(LP)or ml,hr x 37.26(NG). Controls Two-line plain text multilingual LCD Simple user interface for ease of operation. Mode buttons:AUTO Automatic start on utility failure.Weekly,Bi-weekly,or Monthly selectable exerciser. MANUAI Start with starter control,unit stays on.It utility fails,transfer to load takes place. OFF Stops unit.Power is removed.Control and charger still operate. Ready to Run/Mainleranre messages Standard Engine run hours indication Standard Programmable start delay between 2-1500 seconds Standard(programmable by dealer only) Utility Voltage Loss/Return to Utility adjustable(brownout setting) From 140-171 V/190-216 V Future Set Capable Eyerciser.&ercise Set Error warning Standard Run/Alarm/Maintenance logs 50 events each Engine start sequence Cyclic cranking 16 sec on,7 rest(90 sec maximum duration;. Starter lock-out Starter cannot re-engage until 5 sec after engine has stopped. Smart Battery Charger Standard Charger Faull/Missing AC warning Standard Low Battery/Battery Problem Protection and Battery Condition indication Standard Automatic Voltage Regulation with Over and Under Voltage Protection Standard Under-Frequency/Overload/Stepper Overcurrent Protection Standard Safety Fused/Fuse Problem Protection Standard Automatic Low Oil Pressure/High Oil Temperature Shutdown Standard Overcrank/0verspeed((v 72 Hz)/rpm Sense Loss Shutdown Standard High Engine Temperature Shutdown SlandarJ Internal FaultAncorrecl Wiring protection Standard Common external fault capability Standard Field upgradable firmware Standard Rating definitions—Optional Standby:Applicable for supplying backup power for the duration of the utility power outage with correct maintenance performed. No overload capability is available for this rating.(All ratings in accordance with BS5514,ISO3046,UL2200,and DIN6271).Maximum kilovolt amps and current are subject to and limited by such factors as fuel BTU/Megajoule content,ambient temperature,altitude,engine power and condition,etc.Maximum power decreases approximately 3.5%for each 1,000 ft(304.8 m)above sea level and approximately 1% for each 10"F(6 C)above 60 F(16"C)."Sound levels are taken from the front of the generator.Sound levels taken from other sides of the generator may be higher depending on installation parameters. U.S.EPA certified for non-emergency applications. GENERAC 26 kW Switch Options Service Rated Automatic Transfer Switch Features Model G007291-0(26 kW) • Intelligently manages up to four air conditioner loads with no additional hardware. No.of poles 2Current rating(amps; 200 • Up to eight additional large(240 VAC)loads can be managed when used in conjunction Voltage rating(VAC) 120/240,to with Smart Management Modules(SMMs). Utility voltage monitor(fixed)' • Electrically operated,mechanically-held contacts for fast,clean connections. -Pick-up 80% -Dropout 65% • Main breakers are rated for 80%continuous load. Return to utility* Approx.13 sec • 2-pole,250 VAC conlactors. ETL or UL listed Standard + • Service equipment rated,dual coil design. Enclosure type NEMA/UL 3R • Rated for both aluminum and copper conductors. Circuit breaker protected 22,000 Lug range 250 MCM- 6 • Main contacts are silver plated or silver alloy to resist welding and sticking. *Function of Evolution controller • NEMA/UL 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Exercise can be set to weekly,bi-weekly,or monthly Dimensions 200 Amps 120/240,1 e Open Transition Service Rated Height Width H1 H2 W1 W2 Depth in 26.8 30.1 10.5 13.5 6.9 i cm 67.95 76.43 26.67 34.18 17.5 j i i i Wire Ranges Conductor Lug I Neutral Lug Ground Lug i-aevrH w:--i 250 MGM-#6 1 350 MGM-#6 210-#14 GENERAL` 26 kW Available Accessories Model# Product Description 6007101-0 Battery Pad Warmer Pad warmer rests under the battery.Recommended for use if temperature regularly falls below 0°F(-18°C). (Not nec- essary for use with AGM-style batteries). G007102-0 Oil Warmer Oil warmer slips directly over the oil fitter.Recommended for use if temperature regularly falls below 0°F(-18°C). 6007103-1 Breather Warmer Breather warmer is for use in extreme cold weather applications.For use with Evolution controllers only in climates where heavy icing occurs. ' G005621-0 Auxiliary Transfer Switch The auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical load that may not be Contact Kit needed.Not compatible with 50 amp pre-wired switches. G007027-0-Bisque Fascia Base Wrap Kit The fascia base wrap snaps together around the bottom of the new air-cooled generators.This offers a sleek,contoured appearance as well as offering protection from rodents and insects by covering the lifting holes located in the base. G005703-0-Bisque Touch-Up Paint Kit If the generator enclosure is scratched or damaged,it is important to touch up the paint to protect from future corrosion. The touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. G006485-0 Scheduled Maintenance Kit Generac's scheduled maintenance kit provides all the items necessary to perform complete routine maintenance on a Generac automatic standby generator(oil not included). G007009-0 LTE LP Tank Fuel Level The LTE enabled LP tank fuel level monitor provides constant monitoring of the connected LP fuel tank.Monitoring the LP Monitor tanks fuel level is an important step in verifying the generator is ready to run during an unexpected power failure.Status alerts are available through a free application to notify users when the LP tank is in need of a refill. 6007000-0(50 amp) Smart Management Module Smart Management Modules(SMM)are used to optimize the performance of a standby generator.It manages large elec- G007006-0 trical loads upon startup and sheds them to aid in recovery when overloaded.In many cases,using SMM's can reduce (100 amp) the overall size and cost of the system. G0071 69-0-413 LTE Mobile Link''Cellular The Mobile Link family of Cellular Accessories allow users to monitor generator status from anywhere in the world,using G007170-0-Wi-Fi/ Accessories a smart phone,tablet,or PC.Easily access information such as the current operating status and maintenance alerts.Us- Ethernet ers can connect an account with an authorized service dealer for fast,friendly,and proactive service.With Mobile Link, users are taken care of before the next power outage. G007220-0-Bisque Base Plug Kit Base plugs snap into the lifting holes on the base of air-cooled home standby generators.This offers a sleek,contoured appearance,as well as offers protection from rodents and insects by covering the lifting holes located in the base.Kit contains four plugs,sufficient for use on a single air-cooled home standby generator. G007301-0 High Altitude Kit A high attitude kit may be required when operating over 2,000 ft(610 m)above sea level per U.S.EPA regulations.Op- erating the engine with the incorrect engine configuration at a given altitude may increase emissions and decrease fuel efficiency and performance. Dimensions & UPCs Model UK 537.6 mn 121B,n,n (25.1 in( (4B.Q Inl G007290-0 696471087307 G007291-0 696471087314 727.2 mm 128,E lil 0 0 648 mni 1232 n,ni (25.5 url LEFT SIDE VIEW FRONT VIEW 3imeusiws sb w,an awva mate.See imUlatior,manual iot exact dimensions.30 NDT USE THESE NIAMiONS FOR iWALW04 PURPOSES. GENERAC' Generac Power Systems, Inc. • S45 W29290 HWY.59,Waukesha,WI 53189 • generac.com 02022 Generac Power Systems,Inc.All rights reserved.All specifications are subject to change without notice. Part No.A0002026894 Rev.D 0 9/1 912 0 2 2 GENERAC S Automatic FILE COPY Transfer Swit�.o� � Service and non-Service rated Automatic Smart Transfer Switches - 100 - 400 Amps, Single Phase c &S ® LISTED 'CUL only applies to non-service rated switches Description Generac Automatic Transfer Switches are designed for use with single phase generators that utilize an Evolution'M or NexusT" Controller.The 100, 200, and 400 amp open transition switches are available in single phase in both service equipment rated and non-service equipment rated configurations. The 150 and 300 amp open transition switches are only available in a service rated equipment configuration. Standard Features Service rated (RXSW) Generac Automatic Transfer Switches are housed in an aluminum NEMA/UL Type 3R enclosure`, with electrostatically applied and baked powder paint. The Heavy Duty Generac Contactor is a UL recognized device, designed for years of service. The controller at the generator handles ail the timing, sensing, exercising functions, and transfer commands.All switches are covered by a 5 year limited warranty. Non-service rated (RXSC) switches are housed in a steel enclosure. DPM Technology Through the use of digital power technology (DPM), these switches have the capability to manage up to 4 individual HVAC (24 VAC controlled) loads with no additional hardware. When used in tandem with Smart Management Modules, up to 8 more loads can be managed as well, providing the most installation efficient power management options available. GENERAC " GENERAC' 100-400 Amps, Single Phase Automatic Smart Transfer Switches Functions All timing and sensing functions originate in the generator controller Utilityvoltage drop-out......................................................................................................................................................................................................................<65% Timer to generator start..................................................................................................10 second factory set,adjustable between 2-1500 seconds by a qualified dealer' Enginewarm up delay.................................................................................................................................................................................................................5 seconds rStandby voltage sensor..................................................................................................................................................................................................65%for 5 seconds Utility voltage pickup......................... ................>80% ................................................................................................................................................................................ Re-Vansfer time delay...............................................................................................................................................................................................................15 seconds Enginecool-down timer............................................................................................................................................................................................................60 seconds Exerciser ..............................................................................................................................................................5 or 12 minutes adjustable weekly/Bi-weeklyrMonthly— The transfer switch can be operated manually without power applied. `When used in conjunction with units utilizing Evolution" controls "Adjustable via the controller Specifications Model RXSC10OA3 RXSW100A3 RXSW15OA3 RXSC20OA3 RXSW200A3 RXSW30OA3 RXSC40OA3 RXSW40OA3 Amps 100 100 150 200 200 300 400 400 Voltage 120/240.10 120/240,16 120/240,10 120/240,to 120.%240,16 120/240,to 120/240,16 120/240, to Load Transition Type Open Transition Open Transition Open Transition Open Transition Open Transition Open Transition Open Transition Open Transition (Automatic) Service Rated Service Rated Service Rated Service Rated Service Rated Enclosure Type NEMA/UL 3R NEMANL 3R NEMA/UL 3R NEMA/UL 3R NEMA/UL 3R NEMA/UL 3R NEMA/UL 3R NEMA UL 3R UL Rating UUCUL UL UL UUCUL UL UL UUCUL UL Withstand Rating (Amps) 10,000 10,000 22,000 10,000 22,000 22,000 22,000 1 22,000 Lug Range 1!0-#14 250 MCM-#6 600 MCM-#4 or 1/0-250 MCM Dimensions H2 H, Model RXSC10OA3 RXSWICOA3 RXSW15OA3 RXSC20OA3 RXSW20CA3 RXSW30OA3 RXSC40OA3 RXSW40OA3 I Hi 17,24/437.9 17.24/437.9 26.75/679.4 17.24/437.9 26.75/679.4 42.91/1089.9 31.25/793.8 42.91/1089.9 L_• Heigh) oearH w: fin./mm' H2 20/508 20/508 30,,762 20/508 301762 48/1219.2 36/914.4 01219.2 w, W1 12.5/317.5 12.5/317.5 10.5/265.7 12.5/317.5 10.5/25C 16,69/423.9 19.18/487.2 16,69/423.9 Width (in./mm) rW2 14.6/370.8 14.6/370.8 13.5!342.9 14.6/370.8 13.5/342.9 21.82/554.2 24/609.6 21.82/554.2 Depth(in./mm) 7.09/180.1 7.09/18C.1 6.3/160.1 7.09/180.1 6.3/160.1 10.05/255.5 10.06,1255.5 10.06/255.5 H2 H1 Weight(lbs./uilos) 20/9.07 22.5/10.21 39/17,69 20J9.07 39/17,69 140/63.5 133/60.33 140/63.5 I i DEPTH I— w2 GENE RAC, Generac Power Systems,Inc. - S45 W29290 HWY.59, Waukesha,WI 53189 • generac.com y "s' 02017 Generac Power Systems,inc.All rights reserved.AN specifications are subject to change without notice.Bulletin 10003013459-A 04/24/17 Buddine Perrrut Ueck Luc&Zorune Analysis ' Address FSBL• Zones —1 u 1 Conk Typr. V Other. Si6maral Datc ZS 2� RevulOns Submittal Dates: Applicant j rr^ / Nature of Work V `` << Rents ZBA: PB. T: Other. �1EFI) K ( ) FEES Fdmr..\�BP: C/O Flood Plant L.cgaLuaos ( ) ( ) APP: Duel Notarized SBL Truss I.D. Cross Connection H O.A.: ( ) ( ) Scenic Roads: Steep Slopes Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO long Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protecuon S/W Mgmt: Tree Plan Other. ( ) ( ) SURVEY:Dated: Currenc AtchivaL• Sealed Unacceptablr- ( 1 ( ) PLANS Dace Stamped. Soled Copies: Electronic Other. (� ( ) L.iceme: Workers Comp Lability Comp.Waiver. Other. CODE 753#: Dated: N/A ( ) FQGH-VOLTAGE ELECTRICAL PLm: Permit N/A: Other. ( � ( ) LOW-VOLTAGE ELECTRICAL-•Plans: Pemuc N/A: Other: ( � ( ) FIRE ALARM/SMOKE DETECTORS Plains: Permit H W.I.G: Battery _Other- PLUMBING Plans Permit Nat. Gas: LP Gas: N/A/_ Other. ( ( ) FIRE SUPPRESSION:Plans Pemut N/A Other. ( ) ( ) H.VA.C: Plans: Pcmiit N/A: Other. ( ) ( ) FUEL TANK Plans: Permit Duel"Type. Other. ( ( ) 2020 NY Slue ECCC: N/A: Other. ( ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plam: Other. ( ( ) BP DENTIAL i -I`ILR C/O DITIIAL Il:I-IL-R: Other. ( ( ) Other: (' ARB mtg.date: approvaL• notes: ( )ZBA nug.date: approv; ( )PB mcg.date: approv REQUIRED EXLSiING PROP ,tea: APPROVED F�c Etc Bmmc co/1 Q C Tm AcmCo - Sd.H :t _ — Hggb&Z Stones notes: I ,�..� •.iil � r. 'r. r err r�,. ri rl;'. iv t: 1" �r: 'rlfr -?" ly•, S. ].. E[ _ Lo o E sra = 1•.1 � U � �= c s Y t Wo JQ�0`ection CL U) co co Y v y cy M p edap � s. 1 lU J X O Z" I]y f w G IV . ►�i = ci � - ; di ej 4. v 40 U J U �`�J'777 ✓`i •U (a4fr]uNt �N t � ;'fj, ;• �j � _I .' j - _ ,�t•�e r ys Ry:i+j•,• + j' ��.. r.'lyr ;IA '!1 j` I�i• `4 'r..�. !i'11 i}tiA '!1]1r '.i'�,y%i ALMEOIL-05 KLASALLE ,d►�oRO CERTIFICATE OF LIABILITY INSURANCE DATE 812/2 DIYYYY) 12/2024 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 certifcate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Acrisure Insurance Partners Services of NY,LLC PHONE !FAX 90 S.Ridge Street (AIC,No.Ext):(914)937-1230 (A/C,No);(914)937-1124 Rye Brook,NY 10573 gpasa.certificates@cW nsurance.com INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:New York Marine&General Insurance Company 116608 INSURED INSURERS: Halstead-Quinn Petroleum Co.,Inc. INSURERC: 33 Hubbells Drive INSURERD: Mount Kisco,NY 10549 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 I TYPE OF INSURANCE ADDL�SUBR'. POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE S_ CLAIMS-MADE X OCCUR I IPK202300018638 8/1/2024 8/1/2025 DAMAGE TO RENTED 100,000 PRE $_(Ea occyff nce)_$_ PERSONAL 6 ADV INJURY 5,000 _ MED EXP(Any one person f _ _ _ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: [GEMERAL AGGREGATE 2,000,000 X POLICY JE� {!LOC j ' RODUCTS-COMP/OP AGG $ 2,000,000 OTHER _ EBL AGGREGATE $ 1,000,000 A �AUTOMOBILE LIABILITY - M COBINED SINGLE LIMIT 1,000,000 I ll ANY AUTO AU202300017114 8/1/2024 8/1/2025 (Oa"YdQnD_ _ i BODILY INJURY(Per Derson)__S____ i---!OWNED SCHEDULED i AUTOS ONLY _ AUTOS - BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY AMAGE AUTOS ONLY .AUTOS ONLY i _(Per accident A :. X UMBRELLA LULB X OCCUR EACH OCCURRENCE $ 5,000,000 Excess uAB CLAIMS-MADE) EX202300001337 8/112024 8/1/2025 AGGREGATE $ 5,000,000 'DED X RETENTIONS 0I S WORKERS COMPENSATIONLIABILITY i -i.$T$TUTE I __ -AND EMPLOYERS'LIABILITY Y I_N -` - ANYPROPRIETOR/PARTNER/EXECUTIVE .. i E.L.EACH ACCIDENT ___.. S OFFICER/MEMBER EXCLUDED? —J NIA - _ - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under ----- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S I i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is re9u lred) Certificate holder is included as Additional Insured where required by contract or agreement with regard to liability arising out of the Insured's operations per the terms and conditions of the referenced general liability,auto,and umbrella policies. Village of Rye Brook is included as Additional Insured where required by contract or agreement with regardto liability arising out of the Insured's operations per the terms and conditions of the referenced generaliiability,auto,and umbrella policies. 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 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED) o : a r � ^^^^^^ 510423602 KEEVILY,SPERO-WHITELAW INC. Ftz!'1 Y. 500 MAMARONECK AVENUE HARRISON NY 10528 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER HALSTEAD-QUINN PETROLEUM CO, INC. VILLAGE OF RYE BROOK 33 HUBBELLS DRIVE BUILDING DEPARTMENT MOUNT KISCO NY 10549 938 KING STREET RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE G2090 374-6 615693 05/01/2024 TO 05/01/2025 8/19/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2090 374-6, 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 SUR NCE FUND T41/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 883609479 U-26.3 DATE fMMIDDIYYYY) /—i CERTIFICATE OF LIABILITY INSURANCE F07/11/2024 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. 'I HIS CER HFICATE OF INSUR>•NCE DOES NO i CONS T I i UTE A i:ON)RAC T BE-i%NEEN THE ISSUING iNSURER(St,AUTHORIZED' HORiZED 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 Margaret Dodge NAME: Cross Insurance NY-Scarsdale PHONE FAX A/C No Ext: A/C,No): 820 Scarsdale Ave E-MAIL margaret.Dodge@crossagency.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 11 Scarsdale NY 10583 INSURER A: Travelers Indemnity Co of America 25666 INSURED INSURER B: Bil-Mel Construction Corp INSURER C: _ P O BOX 2503 INSURER D: INSURER E: Briarcliff Manor NY 10510 INSURER F: _COVERAGES CERTIFICATE NUMBER: CL2471180882 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A N 300,000 CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A 6809F114865 05/26/2024 05/26/2025 PERSONAL BADVINJURY $ 1.000,000 GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 X POLICY ❑ PRO ❑ JECT LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER $ 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) s OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ _ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER _ ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT b (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ It yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The Village of Rye Brook Building Dept ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street AUTHORIZED REPRESENTATIVE Rye Brook NY 10573 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD RK IONEw Workers' A E Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a.Legal Name and address of Insured (use street address only) 1 b. Business Telephone Number of Insured BIL-MEL CONSTRUCTION CORP 718-328-8548 493 OLD CHAPPAQUA RD BRIARCLIFF MANOR NY 10510 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically 1 d. Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e. a Wrap-Up Policy) Social Security Number 13-4019376 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Property and Casualty Insurance Company of Village of Rye Brook Hartford Building Dept 34690 938 KING ST 3b.Policy Number of Entity Listed in Box"I a": RYE BROOK NY 10573-1226 76 WEG ZR8857 3c. Policy effective period: 12/01/2023 to 12101/2024 3d.The Proprietor, Partners or Executive Officers are X] 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 Rem 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 Worker's 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: Sara Seier (print name of authorized representative or licensed agent of insurance carrier) Approved by: 5a.lal 07/11/2024 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier: (866)467-8730 C-105.2 (9-17) Form WC 88 31 21 F Printed in U.S.A. www.wcb.ny.gov Page 1 of 2 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Tuesday, October 1, 2024 1:37 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 10/01/2024 13:28 To: VIL RYE BROOK PRIMARY Transmitted: 10/01/2024 13:37 00002 Ticket: 10014-001-619-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 8 To: Name: CONCORD PL Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: RIGHT SIDE OF PROPERTY WHEN FACING THE FRONT OF THE PROPERTY FROM THE ROAD NearSt: Means of Excavation: HAND TOOLS Blasting: N Site marked with white: N Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: GAS LINE INSTALL Estimated Work Complete Date: 10/04/2024 Depth of excavation: 0 INCHES Site dimensions: Length 30 FEET Width 3 INCHES Start Date and Time: 10/04/2024 07:00 Must Start By: 10/21/2024 ------------------------------------------------------------------------------ Contact Name: BILL MELNYCHUK Company: BIL MEL CONSTRUCTION CORP, BRIARCLIFF MANOR Addrl: 493 OLD CHAPPAQUA RD Addr2: City: BRIARCLIFF MANOR State: NY Zip: 10510 Phone: 914-582-2468 Fax: Email: info@bgspower.com Field Contact: SHANE MCBRIDE Alt Phone: 914-575-1960 Email: info@bgspower.com Working for: HOMEOWNER- LORI LEVINE ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED SUEZ WTR WESTCHESTER 1 Aft Ik's Lot 9 I 3 S or18'00' w e3.ar i VIUJ%GE Ur!lY'_ar,00K Spat Rd Fsa 1. as N � +o3tLot so. Fr. Lot 7 z Pvc. AC D•�G�� . z ` Spot� IkL a P m VIE = `r JUL 2 72.2� d-6 =��' �� �° �• VILLAGE.OF RYE BROOK • .Y' n ' eo 4z BUILDING DEPARTMENT !) 3 1 2024 `.- ��OF NF1y y ��P A. a D9 ZTOR, ill f Ry*omo CORD PLACE C�ys'� •492aoO� SAND SV Richard Sp Ili Survey of Lot 8 as shown on 'Resubdivision of a 650 Halstead Avenue Portion of Map of Ridge Manor, Section 2, in the Town Mamaroneck, N. Y. 10543 of Rye, Westchester County, New York" (914) 381-2357 Filed on March 21, 1967 as Map No. 15272 N.Y.S. Ur- Land Surveyor No. 49240 Scale 1"=20' August 18, 2011 26/3811 "RIDGE MANOR'