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HomeMy WebLinkAboutMP24-135 �yE DR l� t� i7. �9 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrookny.g_ov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE February 6,2025 Marc Cervoni&Maegan Walton 16 Lincoln Avenue Rye Brook,New York 10573 Re: 16 Lincoln Avenue, Rye Brook,New York 10573 Parcel ID#: 135.65-1-25 This document certifies that the work done under Mechanical Permit#24-135 issued on 10/15/2024 for the installation of a new condenser and eight ductless units have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE DRcb O�` tim 1932 BUILDING DEPARTMENT BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 *- (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - -- - - - - -- -- - ADDRESS : DATE: 202 PERMIT# Z 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 p L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION Q FINAL ❑ OTHER x Qsn M N � � - O O cr In v N \ \ v 99 z Cl. «.� w v c E� cn a ■ w rn U o. rA � A © o a y a N � � w O -0 v �., 1.4 �j O WLn (10 (T1 ~" M ►ir 'i V v o U w 4 � � .yam R, ca A. v ... /•/ w O �7r z W �4J z Uzi Z = r^y �,/ W O � lr ■ A r h 1--i Fri �7 W O ►a 2 V 0 A o � � (� w U00 _ tul a M w ~ va w zo cu U w t v 5o y w a cn a•.--. U W v p U U W Oar., a 0 BUILDING 6I9PARTMENT VILLAGE OF RYE�BfOOK RIOCT - 9 �Q4 ID 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.ryebrooknv.gov BUILDING DEPART"ME T APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: — � 12AApproval Date: \ �' d F ermit Fee: $ 3 00 r� Approval Signature: Othe Disapproved: (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 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. 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 must be listed as certificate holder)& Workers Compensation Insurance on a NYS Board form(Form#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL =$150.00/unit• COMMERCIAL =$450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation.(48 hour notice required 7. Electrical work requires a separate Electrical Permit& Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated, to— Oil�14is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. 1. Address: 16 b1n(01(% AVt SBL: /3S-i(aS Zone: —/d 2. Property Owner: A(fir& UV-V0Ai Address: 16 L.)Acol 1 Aver Phone#: 1 L � Cell#: email: 3. Contractor:: Ae 64A uAs :rot. Address: U30 fQIf i{04 f, Ay Phone#: 7403 — 223 — 91413 Cell#: email: 7166 A 6 t'SAIyLs�OA 4. Scope of Work:New Installation(Y • Replacement( )•Removal( )•Other( ): t� f 5. List Equipment: O 1 T S ! �! • L S fA `i DC t 'b'n e - t (p U-3 o N 6. Location of Equipment: Crl/h / I au r Qll 17OW5 4 ' t, 7. Method Of Installajypn/Removal(list all equipment neededto perform fob): r 6/1/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. ,7L~Sworn to before me this Sworn to before me this day of ,20 day of 0 20M/1 SigRaffre of Property Owner %O%Z4 f Ap Maea" W'4- C Pr' I Name of roperty O err Print Name of licant o lic Notar P Donne M Perri GREGORY M.RNERA NOTARY PUBLIC Notary Public,State of New York State of Connecticut No.01R16441398 f.ty Commission Expires 03/31fM7 Oualifled In Westchester County Commission Expires September 26,206 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 b/1/2024 II II M � � N N w N \ \ rr ., O H 00 1- N W L H ooLn O a C r v CqLn F r ledA� z, = v -00 O z ~04 x ►"'� C Z ►n _ H rr) W N w O Z N ►.� a a � 3 u of : v n a E� �e z ,� ►-� U J V � L' K W U O W zo C � c U w H ��~ v W w x �I m z wv GyE [lRC�v�. _R V BUIL ICE MENT VIL E OF RYE OK ; DEC 11 2024 938 KIN , ET RYE B ,NY 10573 VILLAGE OF RYE BROOK w n BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required C� FOR OFFICE USE ONLY UP-f-- EP#: C�) Approval Date: Permit Fee: $ Z D6 d / Approval Signature: Other: **************************** ********************************************************************* 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 Application dated, /!�R(1, I a 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: Li 4/a0 I n/ Av- SBL: 3.S> p��— a Zone:/ — 0 2.Property Owner:N96;6--A►J Ccr V o n t Address: (o L-iQC.ot-iy Ava Phone#: Cell#: email: 3.Master Electrician/Licensed Installer: /S? Zm P,4(0 Address: Lic.#: (�7 y Phone -41 Cell#: email: k Z#i4RKK0 C4) AOL-, C d h Company Name: - G G D L7=G-AV_iC Address: 3 7`/ VA-1,.519K to tO P n�'e-, 1 s AJV le 3 4.Proposed Electrical Work/Fixture Count: 1 A/a Can dv,s.r G A/c A„e 44,g ya L_. r 5.31 Party Electrical Inspection Agency: -5wi '4 ***,��xxxxxx�x,�*******x,**�xxx*��*xx;.�x;.�***xxxxxx****x*xx�xxxxxxxxxxxxxxxxx�,xx;,,.Kxxxxxxxxxxxxxxxx�xxxxxx STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant(l' state that(s)he is the_�VSsc U 'iz6vCY1 for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best 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 t before me this day of ,20 day�of Q 20 Signature of Property Owner Signature of Applicant Qvs'C-d 1 zRhR►-ko Print Name of Property Owner Print Name of Applicant Notary Public NotaP9MQ7 M.RIVERA Nefary Public,State of New York 6/I/2024 No.01 R164413SB Qualified In Westchester County Commission Expires September 26,2 STATE WIDE INSPECTION SERVICES, INC., Service With InlegrilY 0•0 • • SWIS JOB APPLICATION •2.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect. Permit# 3 Date Bldg Permit# �( — /3 Scl Ft Plumbing Permit# Final Certificate# 1 City/Village Qyt c7CK Zip Building Dept. County Address f / c t o col u N` Cross Street Section Block Lot Owner Nambe/Address(If different than above) �. rvar Contact Number Ce t ❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. [:]Garage ❑Attic 10 Outside ❑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 SERVICE Amperage #Panels iP 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 )unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation �(C. &Cj n J e r+sc c— A. ' DD lIA�a1�r 1 DEC 17 2024 I 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 Z{1 H A r K - Name License# ( 5 (.t) Date �� I r Signature? Address VA ss�r City/State r5hk-,c Zip Code Z , Company L p C>4CL�Q C Phone # 2�c� �p ECIECIC State Wide Inspection Services JAN 10 2025 1080 Main Street cjk--"> Fishkill, NY 12524 To""U S VILLAGE OF RYE BROOK 845 202-7224 Phone BUILDING DEPARTMENT 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: office(a)swisny.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: I.C.D. ELECTRIC Maegan Cervoni Russell Zaharko 16 Lincoln Avenue 374 Vassar Road Rye Brook, NY 10573 Poughkeepsie, NY 12603 Located at: 16 Lincoln Avenue, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP24-236 135.65 1 25 Certificate Number: 2024-9007 Building Permit Number: MP24-135 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: 16 Lincoln Avenue, Rye Brook, NY 10573 The Basement and Exterior were inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below, was found to be in compliance on the 9th day of January 2025. Name Quantity Rating Circuit Type AC Condenser 01 Air Handlers 06 WR/TR GFCI 01 r_✓, 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. ' i $ § ! § k \ § & E § k | ) @� ,® k = *s§ ki ; ■; i ■ ¥ .. �- ; ■F / k| §§ �| C2 ■2 � E - k k § | (k \k - � E !� ■; �} ;# ! i§ ;2 $ ! §\ |§! �;. ■; �fq ■ � g0. ~ $ | �}i\\\}| §§|! i __ ■ � �f). �1�}6 � /| E ■| ■§ l;f� � , ■ r ' J GmW Latimcr 'stC James Maisano WgddraaWCountt Fleentive nt};g Director,Consumer Protection Department of Consumer Protection [-come Improvement License AIR SOLUTIONS. INC. 430 FAIRFIELD AVENUE STAMFORD,CT-06902 'V This license,s icsurd in ae(ordance with AAn clr XVI of the Weawhosnet County Consumef Prµtecf:;m Code and is valid only upon presence,,l the official 4iepartmew seal.Frcwt of citizetr}tip ur immi vtion sta>us is nc+t remind for issuance of this license- r 'SOT FUR F'FI)FRAL PURPOSES License Nwnix.r °� LT e of tixpiration WG3Q7WH 18 I Y 06114/2026 _ !`�gster cvua US-.-- CD�a DATE(MM/DD/YYYY) A CC) CERTIFICATE OF LIABILITY INSURANCE 10/8/2024 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Cross Insurance, Inc. NAME: Rita D'Aiuto Maggi 2 Corporate Drive .203-259-7580 AI PHONE No):203-254-4510 Suite 335 ADDRESS: Sheitoncerbificates@crossagency.com Shelton CT 06484 INSURE S AFFORDING COVERAGE NAICi INSURER A:Selective Insurance Co.of America 12572 INSURED 5085" INSURER B:Selective Insurance Co.of SC 19259 Air Solutions, Inc. 430 Fairfield Avenue INSURERC: Stamford CT 06902 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1700730775 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 ADDLSUBR POLICY EFF POLJCYEXP LTR TYPE OF INSURANCE I jNqn POLICY NUMBER MM/D LIMA A X COMMERCIAL GENERAL LIABILITY S 2513798 4/1/2024 4/1/2025 EACH OCCURRENCE $110001000 CLAIMS-MADE h OCCUR DAMAGE RENTED PREMISES Ea occurrence $500,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY�JECT X LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY $ 2513798 4/1/2024 4/1/2025 COMBINED SINGLE LIMIT $1,000,000 Ee sodden[ X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per a.dent S A X UMBRELLALIAB X OCCUR S 2513798 4/1/2024 4/1/2025 EACH OCCURRENCE $2.000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $2.000,000 DIED I I RETENTION$ $ B WORKERSCOMPENSAT10N WC9098355 4/1/2024 4/1/2025 X I STATUTE IX ERH AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $1,000.000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Property(Replacement Cost) $ 2513798 4/1/2024 4/1/2025 BuildlnnIlg Limit $1.384,646 Deductlble $2500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) C105.2 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook 938 King Street Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE y G aC'C" ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD f' NEW YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board la. Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured AIR SOLUTIONS INC. (203)357-8853 430 FAIRFIELD AVE STAMFORD CT 069027522 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 061543096 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Selective Insurance Co.of SC Village of Rye Brook 3b. Policy Number of Entity Listed in Box"I a" 938 King Street WC 9098355 Rye Brook, NY 10573 3c.Policy effective period n4/nllgro4 to n4/nll?n?.,; 3d.The Proprietor, Partners or Executive Officers are ❑ included. (Only check box if all partners/officers included) �x all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"S'insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers' Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Kim DiMatteo (Print name of authorized representative or licensed agent of insurance carrier) Approved by: /lam 10/8/2024 (Signature) (Date) Title: Senior Vice President Telephone Number of authorized representative or licensed agent of insurance carrier: Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it C-105.2 (9-17) www.wcb.ny.gov