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HomeMy WebLinkAboutMP24-145 6R�k 19 t� Q J�a4C'UV y J 'C VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.ryebrookny.gov TRUSTEES BUILDING&FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE November 22,2024 Rosemary Schlank 9 Bayberry Lane Rye Brook,New York 10573 Re: 9 Bayberry Lane,Rye Brook,New York 10573 Parcel ID#: 129.76-1-153 This document certifies that the work done under Mechanical Permit #24-145 issued on 11/7/2024 for the installation of a new chimney liner has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to 1BUILDINGDEPARTMENT DING 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 : I &-f 62Q La"-)DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: ` � C_-�^ ((T) V �-` V f OCCUPANCY: ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED 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 II N 'n 0 a c w _ it is U F A W L •v p W M z � � .� a W a v 3 Q w oI :^ O C - -.r ^ s 4-4W w m p� ° con W o � w� 00 � v © C� W h a• Q 0W U w `n z Ate ° c. f�] rT� � � ■ W tY I+c w O 'a w aCO00 �1 H CWG O a' E v 4; x a > V o zz . ■ V � � w F � oJ5b V � O x � � H � o .� , w cue U x0 O z v $ ° o M 'Fo i W � w o ° F as,� � � U �••� V v vi w l O Z (� w ZPLO ° O RR �I Po M-41 w VILLF R BROOK D F-C EN E BUI C DEP MENT NOV - 7 2024 938 KING : XE K,NY 10573 (914)939 rooknyxrov VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL, MODIFY AND/OR REMOVE MECHANICAL EQUIPMENT OFFICE USE ON Y, Permit#: /' Building Inspector: Application Fee:_ _ Date of Approval: Permit Fee: A� (� Bldg/LTse Class: Res. O; Comm. ( ); DO NOT START WORK or CONSTRUCTION UNTH.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 REoOIREMENTS FOR-RELEASE-OF PERMI'r" (A CERTEP7CATE OF COMPLIANCE IS REQUIRED TO CLOSE OUT THIS PERMIT) 1. Properly Completed& Signed*Application. ' 2. Payment of Application Fee: residential =$100.00; Commercial=$250.00 (fees are non-refundable) w3. Site/Staging Plan as required*the Building Inspector. 4. Sealed Construction/installation Documents& Specifications as required by the Building Inspector. 5. 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 (Fortn#C105.2 or Form#t126.3/or NY State workers Compensation Waiver) 6. Payment of Permit Fee: Residential=$18.00/1000.00 of Construction/Materials Cost with a minimum fee of$150.00. Commercial=$25.00/1000.00 of Construction/Materials Cost with a minimum fee of$275.00. 7. Inspection by Building Department for removal and/or installation. (48 hour notice required) 8. Any electrical work requires a separate Electrical Permit and Electrical Inspection. 9. Any gas/plumbing work requires a separate Plumbing Permit and Plumbing inspection. Application dated, //—7— c�Y is hereby made to the Building Inspector of the Village of Rye Brook,NY,for a permit for the installation,modification,and/or removal of the specific Mechanical 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 the approved plans,and with all applicable Local,County,State&Federal laws,codes,rules and regulations. /n� �,�� 1.Address: CC% L3 p.�1,c ��� LthN� SBL: /c3 qi7 — —�5-3 Zone: 7f uJ 2.Property Owner: Cti�s c�.o.,.y Sc N N a c Address: •t x.Nc�c e M.C o m Phone#: 0%vy-23'N9-9-2-73 Cell#: email: .CAM, 3.Contractor: Alf-- Address: Szc7�flucktrm� AUK gaMarOr1e �t Phone#: l' 1? 7 � b Cell#: VUY Zqf 1 7-04 email: /!M 6 /1tQ (4 IM f)ej • toll, 4. Scope of Work: New Installation( )•Replacement( )•Removal( )-Other(411f1 5'a/I e 1116i in p- e +J4tng te� 5.Type of Equipment: Neh/ Fn 514-ic1 r , rr n el SvPP�'1 be-�� Pex- /-Lode) 14 YAI,/PIl -�1-ee,/ He= &,y - / 6. Location of Equipment: eA IM,4 f` 13Olf fA l Ve- 7.Cost of Equipment including Installation Cost: S 7 '5 5 6 1 6/112024 STATE OF NEW YORK,COUNTY OF WESTC14ESTER ) as: f'1- 17')a X f t'\L" ,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 Mechanical Equipment 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 Sworn to before me this day of—� '0 day of riw► r,20 Signature of Prop*crty Owner Signature of Applicant R a S 4.r'+ ur f+-1 5 C Vr• r, io►r.l k / �UQI� ( 1 Prin Name of Property OwRFr Print Name of Applicant No tary �1 G ftY M.RNERA t!NO.01FF6350237 c - 5iste of New York Netary Public,State of New Fork No.01RI6441398 Westchester County Qualified In Westchester County on Expires Nov 7 2024 it Se tembe 26,ZO � ���i`�'aii�on gnust�e pro erly completed in its entirety and must include the notarized signatures) 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/l/2024 . Phone:888-900-8106 SPECIFICATION SHEET Fax:888-392-4432 FOR BEST-Flex Model "H" Web:www.NewEnglandChimneySupply.com STAINLESS STEEL CHIMNEY LINERS 280 Commerce Street,Williston VT 05495 BEST-Flex Model "H" P•Npi• III a STAINLESS STEEL CHIMNEY LINER BEST-Flex Model"H" Stainless Steel Chimney Liner is manufactured by New England Supply Inc. Located in Williston, VT. The BEST-Flex lining system is designed and UL listed to be installed inside masonry chimneys. BEST-Flex liners are used to vent the flue gases and combustion byproducts produced by appliances that burn oil, gas, or solid fuels. BEST-Flex Stainless Steel Chimney Liners are tested and listed by Underwriters Laboratories to UL 1777& ULC-S635 PRODUCT INFORMATION FOR BEST-Flex Model "H" CHIMNEY LINER • The BEST-Flex Stainless Steel Flexible Chimney liner is designed to reline existing chimneys or to be used as a liner in new construction. Manufactured with the highest quality, mill certified alloy. BEST-Flex Stainless Steel Flexible Chimney Liner has a high acid fighting capability. Listed by UL Laboratories to UL 1777& ULC-S635 standard for zero clearance installation. BEST-Flex can be used to vent wood,wood pellet, coal, non-condensing gas and oil, making it the choice for venting all standard efficiency installations. BEST-Flex is available in 3"to 18" diameters to cover a wide range of requirements found in the field today. • The unique manufacturing systems used to make BEST-Flex utilizes a continuous strip of stainless steel, 4-ply interlocked to produce a gas and water tight lining system of superior strength and durability. BEST-Flex can be curved to go around offsets in chimneys and can be shaped to custom sizes to fit most any installation requirement. The flexible construction allows for expansion &contraction during the heat up &cool down periods which removes any stresses on the system. • BEST-Flex can be insulated with either a vermiculite based poured insulation or with a foil-faced ceramic wool blanket to meet UL 1777& ULC-S635 standards for chimney exteriors with zero clearance to combustibles. • BEST-Flex Stainless Steel Chimney Liner comes with a Life Time Warranty for all fuels,with appliance efficiencies at 83 percent or lower. • Refer to installation instructions for detailed installation information. SPECIFICATION Metal Alloy 430, 446, 316L, & 304 Stainless Steel Thickness .012" - .018" Mill Certified Yes UL Listed Yes 3"-12" (UL 1777& ULC-S635) Available Diameters 3"—20" Manufacturing Process Spiral wound 4-ply interlocked Revised 5/22/2013 Mr Chimney Clean, Inc 529 Rockland Ave Mamaroneck NY 10543 (914)777-8200 info(cDmrchimney.com mrchimney.com Service Information - Invoice Rosemary Schlank j 9 Bayberry Ln - -- Billing Information Rye Brook NY 10573-1501 - - Contact: Rosemary Schlank Rosemary Schlank ,�� Phone: (914)939-9273 9 Bayberry Ln Rye Brook NY 10573-1501 i w' Alt Contact: Alt Phone: E-Mail: rschlank@ix.netcom.com I Marketing Campaign Job Name ❑ Call Ahead ❑ Confirmed PC Schlank,Rosemary 21465 Sales Rep Terms Type Class GS Due on receipt Residential Job Type PO Route Scheduled Start End Liner - Office 11/2/2024 09:00 AM 09:15 AM Description - Quantity Rate Amount Install a HEAVY GAUGE all fuel smooth wall stainless steel boiler flue chimney liner,a stainless steel t- 1 $3,550.00 $3,550.00 connector,a stainless steel top plate&a rain cap. The stainless steel liner comes with a lifetime manufacturer's warranty. Job Subtotal: $3,550.00 CAP. IMPRV $0.00 Job Total: $3,550.00 Payment Total: $1,775.00 Account Balance. $0.00 Total Due: $1,775.00 Our company requires a 50%deposit when the job is scheduled and balance paid upon completion of the work. The consumer and the contractor have the right to cancel this agreement for any reason whatsoever and at any time prior to midnight of the third business day after the agreement is signed. Payment is expected at time of service. Late payments are subject to 1.5%late fee per month calculated from the day of service. Returned checks result in a$35 returned check charge.We gladly accept Zelle(info@mrchimney.com) 'There is a 3.5%Administration fee for credit card charges$1,000 and up. � c . . c (Li ce 0 0 T O j p CDim zo ...� p W d 3 � a 1 Q Q ! > C f! Z , 1 , ♦ ea � � r M f. c E W z Ci 1 `i O C o y G o O G �" 1 IF v i O W t= I• a 0 � _ � Q (� O a) z _ , W o 14 E L m Ct 'J 1 ^ 3 R F-+ x s 0 la a o O �w Co)o � tn W ve— T a 0 d W W _ = � a W J � cn .. - � inZ 3 w CU s o w - 1- 0 I C W � m 2 lL1 E O W t13 m cc t W uj C/5 .� cc o O Q LULAa > o la U- 4 C O m C 'L >t e y^rp •- MTd ,.�. - c ` D Q `0 ! :. ii ;-,� ti' � � . .. ... .. .. . . • � o pO � �s� prx , -tl • � G '� ,L; LO �� 1 1.0 • ??.. •~ O rR O �` 14 •tl;.��y�``.>f? LLJ 4, • 4d O Cd m '' aLJ CdLU rn � J 7 W ~ Q ' 0 W Z J ui a ts.G� J r 1 Q z Y R ZQ a.1 4-o Q.! = Q Q Q O wrae a LO v tU u U 0 m 04 T oe � tiy'xy� i 'wwg yf i .I+t�l+llr+�� .. r 1 ! ..• ` ; ,..�++-.1 - -r F`fir+ '+ff t.s4 _ .: +r l�s +<( ��,•} s's- LIS A��0 7EJ(MMIDDYYYY) C" CERTIFICATE OF LIABILITY INSURANCE /06/2024 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 NAME: Sean O'Keefe Affordable Contractors Insurance,LLC PHONE , (888)652-4513 NC No: (888)274-7438 PO Box 2389 AE'SAILDDRE , info@acisaves.com INSURERS AFFORDING COVERAGE NAIC S Gilbert AZ 85299 INSURERA: SUTTON SPECIALTY INS CO 16848 INSURED INSURER B: Mr.Chimney Clean Inc INSURER C: 529 Rockland Avenue INSURER D: INSURER E: Mamaroneck NY 10543 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE INSURANCE ADDL SUER I=Jima POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 NTED CLAIMS-MADE a OCCUR PREMISES E occurrence DAMAGE TO RE $ 50.000 MED EXP(Any oneperson) $ 5,000 A X X ISCP04000035495 07/09/2024 07/09/2025 PERSONAL&ADV INJURY $ 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 1,000,000 X POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per aocident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S LIABILITY W AND EMPLOYERORKERS COMPENSATION P R OTH- ER EMPLOYERS'LIABILITY f N STATUTE ANY PROPRIETORIPARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $ /M OFFICEREMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOY $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ -7 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) HOLDER NAMED ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 King Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ORK Workers' STATE Compensation CERTIFICATE OF Board NYS WORKERS'COMPENSATION INSURANCE COVERAGE la.Legal Name&Address of Insured(use street address only) lb.Business Telephone Number of Insured Mr.Chimney Clean,Inc. (914)777-8200 dba Mr.Chimney Clean,Inc. lc.NYS Unemployment Insurance Employer Registration 529 Rockland Ave Number of Insured Mamaroneck,NY 10543-2222 Work Location of Insured(Only required if coverage is.specifically Id.Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e.a Wrap-Up Policy) Social Security Number 133898629 2.Name and Address of Entity Requesting Proof of Coverage(Entity 3a.Name of Insurance Carrier Being Listed as the Certificate Holder) Continental Indemnity Co. Village of Rye Brook 3b.Policy Number of Entity Listed in Box"la" 938 King St 46-261997-01-10 Rye Brook,NY 10573 3c.Policy effective period Attn:Project Manager 07/29/24 to 07/29/25 3d.The Proprietor.Partners or Executive Officers are ❑ included.(Only check box if all partnerstofficers included) ® all excluded or certain partners/officer-,excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"la"for workers' compensation under the New York State Workers'Compensation Law. (To use this form,New York(NY)must be listed under Item A 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"T'. 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: Todd Brown (Print name of authorized representative or licenced agent of insurance carrier) Approved by: ��— 11/06/2024 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: (877)234-4424 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