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HomeMy WebLinkAboutFire Inspection Certificate 2024-2027 M xz � � x a Hu ao a w � � o WC4 Fil wwo � � w A 1 V O U � x F w 04 u � A 00� H 0-4 O z O H O c W ►7"'i wwwaLf z A W � � N N a ~ L, ~"zo � AA z � 00 � w �, � xC7 A o H M wwz ' W w N xP-4 w w x H H O O 0-4 W H W A U U cn z � zz A W 00 Cl) 04 l� ►7 � '�� U�`", can W ►- c/ W a cn R-4 H a z a, �yE BRO 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 : i - DATE: I PERMIT# ISSUED: SECT: //1•3f BLOCK: - LOT: :)'-- LOCATION: vA OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... Q' ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION Q ❑ NATURAL GAS _ / P ��v 141 L-- ❑ L.P. GASG. 24L j 1,r� ❑ FUEL TANK❑ FIRE SPRINKLER 4- ( sSCZ 2 � c, _ c ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL (� OTHER �►ZQ B a FI L D ING D Il PARTMENT VILLAGE a .R.YE BROOK Initial Inspection Date: ❑ Ilams STI-WEN E.Fi s 938 KING STRr>rn-,Rvir,.BROOK,NEW YORK 10573 /O- 1- 2 o Lq X'I ail Butt.DiNG&FIRE INSPECTOR (9:14)939-0668• f AX(914)939-5801 Re-inspection Date: ❑ I aKs stcvctbwscu!rvchrcx►k.o www.r�yebrook.or•! Pail I+IRE INSPF,C'I'ION REPORT, NO'rlci; OI? VIOLATION & ORDER TO REMEDY SAME Site Address: STT"-Zone: f-�SBL: Occupancy:._C -�1 S F a2 MA ��N ------ -- 3 N Phone: 93y' g�O Building Owner: L�_�1 �4e, ��� �--Phono: 9/y- 7©/ - y0Q� -s-- Emergency Contact: xQ - - - -- -Phone: Building Representative in Attcmdance:—QN Z� /�r_1 O _--r d a*j . Take notice that the following violations of the New York Slate U11il'00M fire Preyention&Building Code and/or the Code of the Village of Ry Brook were found to exist at, - >�j� Q 1 d ST NY on e r ,in the Village of Rye Brook, ' 20.2 -.You are hereby directed to Votain the necessary permits and to correct all violations imtuediately.You are further directed to conkict the Building Department during normal business hours to schedule a re- inspection of the premises to confirm that all violation~have teen correctcA kind that the premises is in full compliance with all applicable codes,laws,rules&regulations-Be advise.((that your failure to comply with the directive, contained herein and to correct all violations is a crime puui-,liable by tine,inrpriso nrrcnl.or both. ---- ------------------------------------------------------------------------------------------------------ I.PORTABLE RIRF)EXTiNCUiLSHEMS (EFF''s) No is N/A a.906.1 Are PFE's installed throughout the space;,&oil file preirtiscs as required by code. a. _b.906.3.1 Is the maximum travel distance to a PFT 75 feet or less. b - - c.906.5 Are PFE's conspicuously located&readily accessible. -- d.906.6 Arc PFE's unobstructed/uuobscur c-A from view. C. 1 1 ' - e.906.7 Are PFE's properly mounted as per the manufacturer%instructions. d.� - f 906.9 Are PFT's installed so that the top is not lip Jrcr there 5 feet above tlrc floor. e -- 2.FIRF ALARM SYs'IT:M&SMOKE DP,'rlsCl•ORS a.901.6.1 Is the fire alarm system insl-vutod,tested.t maintained in accordance with NFPA 72. - - b.907.4.1 Are manual pull stations located within 5 feet of . it.&with 200 feet of each other. a. c.907.4.2[s the heiglit of the pull station.handle locaatccl be.tweon 42&48 inches above the floor. b - - d.907.3 Is a fire talarrra system provided in existing d.uildiups as per sccixon 9()7.3.1 &907.3.2. d. 3.FIRE 8PRINKL9R SYSTEM&FIRE FFYDRANTS a.901.6.1 1%the sprinkler system inspected,tested&nraint-ainel in accordance with NF13A 25-13. b.901.6.1. Are the main valves secured against tampering in the open position. b. a.- - c.901.6.1 Are sufficient clearances maintained f-om fire sl,rinklcr hca&%to fixtures or materials. C.- d.901.6.1 Is a supply of six spare licads&a wrench oraintiaiued on the premises. d - c.901.6.1 Are sprinkler heads&cover platers unfinished or of ractory applied finish only. a -- f.901.6.2 Are records of all system inspections,tests&mkantenancc report~maintained on the premises. r_ g.913.5 Is the fire pump inspected,tested&nraiul aine:ed in accordance with this section&NFPA 25. _ - h.508.5.2 Is the fuc hydrant system properly maintained,operational,compatible w/NST&tested annually. 1. i.508.5.4 Are fire hydrants&fire protection equipment auiobstnactcd. -j.508.5.5 Is a clear space of not less that 3 feet undulcaincd around all Hydrants. r INSPE("MR: '��— ' ---]DATE Z O . - —Z—— — 1. I;cvi=[2/10/t 1 4.STANDPIPE,CABINETS&FIRE i?Jca Yu?h N/A DEPARTMENT CONNECTIONS __- a.901.6.1.Is the standpipe system inspected,tested&maintained in accordance with NFPA 25-14. a. _� _ b.901.6.1.Has the required flow test been performed within the past 5 years as per NFPA 25-14. b. _ v,' c.905.1.Are FDC threads in the standpipe system compatible with National Standard specifications. C. d.905.7.Are cabinets containing fire fighting equipment unobstructed/unobscured. d. _ e. 905.7.1.Are cabinets containing fire fighting equipment properly identified&labeled. e. _ f.912.2.1.Are exterior FDC's fully visible&recognizable from the point of fire department access. g.912.3 Are FDC's unobstructed and available for immediate access by the fire department. g. 5.EXITS.MEANS OF EGRESS&OCCUPANCY a. 1028.2.Are exits&exit enclosures continuously maintained free from obstructions or impediments. a. b. 1028.3.Is the means of egress flee from obstructions including accumulated ice&snow. b. _ c. 1028.5.Are exits maintained unobstructed by furnishings,decorations,draperies,mirrors,etc... C. _ d. 1028.6.Are existing emergency escape&rescue openings maintained as per this section. d, _ — e. 1029.2.Are egress doors readily operable from the egress side as per this section&Section 1008.1.8.3. e. f. 1029.4.Are all spaces having an assembly occupancy posted with an approved occupant load sign. f. g. 1029.7.1.Are exits marked by a properly located,approved&readily visible exit sign. g. — h. 1029.7.1.Is the maximum travel distance to any exit sign in an exit access corridor 100 feet or less. h. _ i. 1029.7.3.Are all stairway exits provided with tactile exit signs in compliance with ICC/ANSI 117.1. i. j. 1029.7.4.Are all exit signs illuminated at all times. j k.1029.8.Are the means of egress&exit discharge illuminated at all times the building is occupied. k. X _ 1. 1029.11.1.Are public aisles in group B&M occupancies maintained at least 36"wide where fixtures 1. are placed on one side of the aisle&at 44"wide where fixtures are placed on both sides. m. 1029.11.2.Are non-public/non-accessible aisles serving less than 50 people maintained at least In. 28"wide,or at least 36"wide where serving 50 or more people. — — 6.COMBUSTIBLE STORAGE&WASTE MATERIALS a.304.1.Is premises&building maintained free from accumulated combustible waste material. a. b.304.1.2.is property free from weeds,grass,vines or other growth capable of being ignited. b. —C.304.2.Is combustible rubbish stored so as not to create a nuisance or hazard to the public. C. — d.315.2.Are combustible materials properly stored&separated from ignition sources. d. — e.3153.1.Is storage maintained 24"or more below the ceiling in nonsprinklered buildings, e. —and 18"or more below sprinkler head deflectors in sprinklered buildings. — — f.315.2.2.Are exits&exit enclosures maintained free from stored combustible materials. f g.315.2.3.Are boiler,mechanical&electrical rooms maintained free from stored combustible material. g. — — h.313.1.Is building maintained free frorn stored fueled equipment.(motorcycles,mopeds,mowers,etc...) h. 7.ELECTRICAL a.604.1.Are emergency&standby power systems properly maintained. b. 605.1.Is the building free from modified/damagedb wirin j, appliances,liances a. ",equipment and b, maintained free from electrical hazards. — — c.605.2.Are electrical service equipment areas properly illuminated. C.d.605.3.Are proper working space clearances provided&maintained for electrical service equipment. d. v/ — e.605.3.Are electrical service equipment working spaces free;from any stored materials. e. _ — f 605.3.1.Are all electrical control panel room doors,panel boards&disconnects properly labeled. f — g.605.4.Is the building free from unfusedlmulti-plug electrical adapters. g � — h.605.5.Are electrical extension cords being used in a safe manner as per code. h. X i.605.6.Are all junction,switch&outlet boxes fitted with approved covers or plates. i. j.605.6.Is the building free from open-wiring spliced electrical connections. j — k.605.8.Are electrical motors maintained free from accumulated oil,dirt&debris. k. _V-7 — 1.610.Are Carbon Monoxide Detectors installed&maintained as required by code. I. X INSPECTOR:�.�i `� --DATE: 2. Revisal 2/10/11 3.V1 XVXrOlts,DUMIawAITirRS&ESCALATORS ATORS a. f.f'Ml 606.1.Are elevators properly maintained,and is the current certificate of inspection on the premises. a. b. 607.2.Are approved standardized,pictorial signs posted adjacent to each elevator call station on all b. � floors reading; IN hntn;I�:MI?It(:1?Nry 1/�►Ntrr I ISI;I;I,l:vn'r(►le I Itiv ir�rr ti rnoiti — — c.607.3.Are keys for elevator car doors&lire(Icpartmcnt service kept in an approved location. C. _ d.315.2.3.Are elevator machine rooms maintained lino from stored combustible material. d. _ JL e.[1313006.1.Are elevator machine room doors tataintainsxt i-wobs-hucted at all times. e. _ _ _ 9.COMMERtCiAI,KITCiiENS a.904.11.5.Arc portable Classy K:lire extinguishers within 30 feet of cooking equipment. a. _ b.904.11.6.1.Is the lire protection equipment inspected,tested&maintained as per Section 901.6. b. _ c.904.11.6.4.Are automatic fire extinguishing systems serviced at least every 6 months&after system C. _ _ X activation,and is the certificate of lust) tiou forwarded to the code enforcement official. d.904.11.6.5.Are fusible links&automatic sprink ter heads replaced annually. d. — — X 10.111KATiNG Syti rFms a.[PM1603.1.Are all heating appliances properly installed&maintained in a safe working condition. a. It.[PM]603.2.Are all fitel-burning appliauc -s&equipmu nt conuect:ed to an approved chimney or vent. b. _ R/ c.[PM1603.3.Are heating appliances maintained with proper clearances from combustible material. C. — d. [PM)603A.Arc safety controls 1'or file] -burninL;csluitmceut ruaintztitcecl in cflcctive operation. d -- — — e. [PM1603.5.Is the fuel-burning equipment provided with adc(lua.tc combustion&ventilation air. e. — 11.MOTOR F11Ll,ll)ISI'i.NSIN(FAC'l1,ITlrti&12R�,awR CARA(:1e.S a.2203.2.is an approved,readily identifi d�V1,readily aucssible emergency disconnect switch provided a. in an approved location within 1.00'of,but not loss t:hatt 20'from fuel dispensers. — — b.2204.3.4.Are dispenser operating itasttvctiotas cotnsliicuorasfy posted on every fuel dispenser. b. c.2204.2.4.Are fuel-dispensers unobstructed,& in clear view of the attendant at all tithes. C. — d.2205.5.Are approved portable fire extinguishers complying with Section 906 with a minimum rating of d. d( 2-A:20-B:C provided&located not more than 75' trout putups,dispensers&fill-pipe openings. — -- c.2205.5.Are watuiug signs provides[&posted within sight ol-each dispenser as per this section. e. �( f.2205.7.Are combustible materials kept at least:"10' flroin fuel-(candling equipment. f — — — g.2206.4.Are above-ground tanks provided with vehicle impact protection. g. — — It.2206.5.Are above-ground tanks provide([with Secondary — — -x spitl contiawutent. h.h. 12.HA%ARiIO IN MATERIAL 5 c. 407.2.Are M.S.D.S.for all h:uardous materials readily available on the promises. a. d.407.3.Arc spaces and individual containers containing;haz-mat~properly labeled&identified. b. a 2701.4.Are haz-mats reported ailttllally as required by Ciem"n I Municipal Law Section 209u. C. d.2703.7.1.Arc proper No SMO MNC signs provided:is per this section. d. 13.MiSCELLANI,0118 — — a.404.2. Is an approved Fire safety&evacuation Phan prepared&maintaincd for the building/occupancy. a. X b.405.2. Are emergency evacuation(trills conducted at fhc intervals as specified in Table 405.2. b. � — — c.405.5.Are reecord%kept&maintained on the pr eillises Corr 011ergency evacuation drills. C. X_ — — d.505.L Are approved address&building ntluabeas properly placed&plainly visible from the street. d. _— e.506.1.Are approved key boxes(knox ix,xcs)provided,property.located&equipped with the proper keys. c. _— f 703.L Is all required fire-resistaucc rated construction properly ui;tintainexl as per code. f — g.703.1.Arc operainbs through fire-resistance steel assemblies properly protected&maintained. g. _ — h.3003.5.Arc compressed gas cylinders&systcucs secured.�V'sa l'eg uardcd against damage&access. h. i.3003.6.1.Are compressed gas cylinder caps or collars in place at:all times except when tanks are in use. i. 14.Gii.NERAi,HOUXWERPING a.Good b.Fair ---- c.Inadequate --- — a d.Poor IMPFC701R: .t R(,visW 2/10/f I J IT1rM NUM13m REMARKS I ,%--) Reu„ F kA,r,07A C 's A . ALSo PAlk .,, LT G, n'1 Grc I ^ -t S /'oct ho t u s'-LVtCP x s v A-; S N o Vs S l� F� 0-7 6��� Pt�" 716 . S M E t %S U-5 G N s uko .5A � ,TJ /V. A ;N C. boa 1''?o�to�c t� c ✓isi� (i A. A Nee e Pcu iUs _ 2e co ,te, !,Lf A7 . T o�� ree i�j No Wp,2 r Q> �e Cnole.�,�.� 4 roc. R ?) 19QLA 570_�, a P !h.e "e,e s jci be e.,-PU Q G2a Ve s 0 so ,c� INSPECTOR: DATE: Y 4. Revised 2/10/11 D BUILD MENT SEP - 6 2024 DD VI E.Oik-Y OK VILLAGE OF RYE BROOK 938 KING J EETRY'E_' R K NY 10573 BUILDING DEPARTMENT Q9 rod Zo FIRE INSPECTION / OPERATING PERMIT APPLICATION FOR OFFICE USE ONLY: Fee Paid: $ Inspection Date&Time: FEE SCHEDULE: Re-inspection Date&Time: Triennial &Private School Annual Inspection:=$450.00 Public Assembly Annual Inspection: <100 People=S525.00 />100 People=S775.00 Application,dated: C�� 1 ,is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting that a Fire Inspection be conducted at the building and premises listed below for the purpose of issuing a Permit to Operate the business, private school and/or place of public assembly in conformance with the Code of the Village of Rye Brook,the New York State Uniform Fire Prevention &Building Code,Title 19 NYCRR Part 1201, and all other applicable local, County, State & Federal laws, rules & regulations,as per detailed statement described below. 1. Address: I•Ll 131'dQe 5fi SBL: )gl.�5 .,2 - Zone: C - p 2. Business/Occu ane Name: C 'S /'�h < S'j7Q NYS Use Class: P Y 4 !=-L1�r��� 3. Property Owner: ,',w �j�p4EEr-Ai TY L C C Address: IN h�e_ Ri iej t _ �c�ZC� Phone# �J/({- �G J �(QL>> Cell# — email: Gthakc,n j.n& 1 t ti(i��c{e.0 c), 5. Business Owner: C V S i'l I/-)LInt i Lu Address: 032 2 SC,U i k R 1'JG st. Phone# 9111 -013y-%Iq Cell# email: �-SU53�G�'CL'Stieallj-�.to�ti� 6. Emergency Contact: Address: Phone# C�I� ��� `��,I�f Cell# email: lXau,e�. �j�l6zj�LtU>1l�rli�),<cn 7. Inspection Escort: cia0friy Pkfcy(�y Title: Phone#: 9IL) - q")Lj-�6j9 Cell#: 8. Provide a brief description outlining the current and/or intended use of the property: 9. List all Hazardous Materials: l')Gi1 6 10. Occupant Load: Existing: Proposed: Other: 11. Date&Disposition of Previous Fire Inspection: O Pass D Fail 8/12/2021 This application must include the notarized signature(s) of the legal owner(s) of the above mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW-Y13RK ) COUNTY OF WESTCHESTER ) as: Joshua J.Smith being duly sworn,deposes and states that he/she is the applicant above named, (print name of Individual signing a placation) and further states that he/she is the legal owner of the property to which this application pertains,or that he/she is the CVS A �a ti�4 L; 4C, ,for the legal owner and is duly authorized to make and file this application. That all (indicate architect,businos owner,attorney,agent,etc.) 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-<;6PkM 6 t:N� ,20 day of Zwi , 20 i LI Vx( 6iotar pblic Notaly�ubli i , t Signature of Property Own r rSig�j�rure of plicant Alena HakeniinS Print Name of Property Owner Print Name of Applicant e M. G b"Wc3o�u RICHARD A. YARMY 11 ��, 01woft - mm. . o1� NOTARY PUBLIC,STATE OF NEW YORK Notary Ems Alt t 24 Registration No.OIYA0013323 Qualified in Westchester County � A(lbl is Commission Expires September OS,2027 a 0�RhOt1 e Zs�a� 2 sn2Y2021 i o Z U s sN cz o zo CIO CL vi '_ � .9 a^9q��,,JJ Yffff Yf _� i C�� -{ �• � 8 � s E S£E e sj. q � 33€pp $ gg a tS � •�• �s fi aa� a 'e sg � d3 a11 WITSIR N sill t 5 5 ® 1 EI$ 5 � 1 a ads ale 5 5 � � 4 0 Ytl H�E5�9Otatfi/a V CVSHealth August,23 2024 RE: Business License Renewals Dear Sir/Madam: Enclosed please find completed application(s) and/or appropriate payment(s) for the Business License Renewal(s). Please note any changes made on the application(s). When the new license(s) is/are issued, please send it to Mai/Code # 1160 at the address below or PO Box E Woonsocket RI 02895 After making the necessary copies for my files, I will forward the originals to the stores for posting. Thank you for your cooperation in this matter. If you require additional information or have any questions, please free to contact me at (401) 770-6090; Fax # (401) 652-9248 or by email lisa.gonzalez@cvshealth.com. Sincerely, Elsa cook zalez Lisa Gonzalez Analyst,Corp Svcs. Licensing One CVS Drive. MC # 1160 Woonsocket, RI 02895 lisa.gonzalez@cvshealth.com Enclosure(s) CVS pharmacy / caremark / minute clinic / specialty 0illiam Hird&Co,Inc. Tel. 718-499-4881 EI N 11-2324325 Fax. 718-499-5571 License # FDNY PFE 128W 255 40th Street www.hirdco.com NYC MFSPC 828C Brooklyn, NY 11232 NASSAU PEL183-AEL290 SUFFOLK 115, NJ P00260 CUSTOMER JOB NO. 26932 - 39844 - Cesar Gil ANNUAL- PFE SERVICE Customer Details Site Details -_- Name FOOS FIRE INC. (CUSTOMER) Name CVS 5350 l Address 909 MARCONI AVENUE Address 182 SOUTH RIDGE STREET RONKONKOMA NY 11779 RYE BROOK NY 10573 I Contact Contact MOD Telephone 631-689-6869 Telephone (914)934-9619 Mobile Mobile Fax 631-689-6866 Fax Email N/A Email Work Requested PO: 18863 STORE HOURS: MON -SUN 8AM -10PM i { SERVICE PORTABLE FIRE EXTINGUISHERS IN ACCORDANCE WITH NFPA-10 and/or AUTHORITIES HAVING JURISDICTION AT INTERVALS OF NOT MORE THAN (1)YEAR. 3 ""TECH: MUST ADD A NEW ASSET FOR ANY NEW OR SWAPPED PFE'S- RFM FROM 11/2022-(3) 5LB ABC -(1) 10LB ABC 51LB ABC-1ST FL. LUNCH, SALES REC. STK. PHARMACY-(1) 10LB ABC PHARMACY UNDER BACK SINK J Work Order Details Customer Purchase Order — - Customer Tracking Number 'Ichedule 11/09/2023 11/09/202 1 10:00 AM 02:30 PM 02:15 PM 03:15 PM 1.00 hts I Asset Re ister-PFE Fire ExtinguisherAsset ' • Floor •• New FDNYDate Pass I Fail 26047 1 1st Pharmacy I BADGER 151b ABC NaTest 11/09/2023 Fail ! Action taken::RFM Removed to shop for 12yr Hydrotesting Edit Asset with New FD TAG#: No Readings Shop Techs Action Taken on RFM Units: NOR - - 26048 1 st I Sales 14 back 'AMEREX 110lb ABC Na 11/09/2023 Pass Test Action taken::Left in Service .Edit Asset with New FD TAG#:No Readings Shop Techs Action Taken on RFM Units: ..... i -_...- ---- - .......- - -- - ji ZAction I Rest rms BADGER 51b ABC Na 11/09/2023 Fail ` en::RFM Removed to shop for 12yr Hydrotesting Edit Asset with New FD TAG#:No hs Action Taken on RFM Units: _--._..._._................. ------ - - -- --- Page 1/3 illiam Hird & Co, Inc. Tel. 718-499-4881 EIN 11-2324325 Fax. 718-499-5571 License# FDNY PFE 128W 255 40th Street www.hirdco.com NYC MFSPC 828C Brooklyn, NY 11232 NASSAU PEL183-AEL290 SUFFOLK 115, NJ P00260 CUSTOMER JOB NO. 26932 - 39844 - Cesar Gil ANNUAL- PFE SERVICE Asset Re inter- PFE Fire Extinguisher 26050 1 1st Lunch OTHER 51b ABC INs 11/09/2023 IFail - - i Action taken::RFM Removed to shop for 6yr Maintenance Edit Asset with New FD TAG#:No Shop Techs Action Taken on RFM Units: F 26051 1 st !Sales2l back OTHER 101b ABC INa Not Tested Action taken:: Edit Asset with New FD TAG#: Shop Techs Action Taken on RFM Units: j 26052 1 st _ Lobby main entr. 1 BADGER 51b ABC Na 11/09/2023 Fail Action taken::RFM Removed to shop for 12yr Hydrotesting {Edit Asset with New FD TAG#:No Shop Techs Action Taken on RFM Units: l 26053 1st Sales4 BADGER 101b ABC Na 11/09/2023 Pass E Action taken::Left in Service Edit Asset with New FD TAG#:Yes Shop Techs Action Taken on RFM Units: 26054 1st Salesl KIDDE .51b ABC Na 11/09/2023 lFail E Action taken::RFM Removed to shop for Recharge only Edit Asset with New FD TAG#:No Shop Techs Action Taken on RFM Units: 26055 1st 3 Rec stock exit BADGER I 51b ABC Na 11/09/2023 Fail panels 1 Action taken::RFM Removed to shop for Recharge only Edit Asset with New FD TAG#:No Shop Techs Action Taken on RFM Units: I 26056 1st Rec.stock BADGER 101b ABC Na 11/09/2023 Pass harmac Action taken::Left in Service Edit Asset with New FD TAG#:No Shop Techs Action Taken on RFM Units: I 26057 1st Cust.service BADGER 51bABC Na 11/09/2023 Fail - — _ Action taken::RFM Removed to shop for 12yr Hydrotesting Edit Asset with New FD TAG#:No Shop Techs Action Taken on RFM Units: 34676 ;1 st Sales2l !AMEREX 1101b ABC Na 11/09/2023 Pass Action taken:: Left in Service Edit Asset with New FD TAG#:No • . l Shop Techs Action Taken on RFM Units: i k Miats Required �� ." Description Rexuired Already Used Still Req'd Used PPO ANNUAL PULL PIN OPER. & 4.00F7 4.00 0.00 Page 2/3 illiam Hird & Co, Inc. Tel. 718-499-4881 E I N 11-2324325 Fax. 718-499-5571 License# FDNY FIFE 128W 255 40th Street www.hirdco.com NYC MFSPC 828C Brooklyn, NY 11232 NASSAU PEL183-AEL290 SUFFOLK 115, NJ P00260 CUSTOMER JOB NO. 26932 - 39844 - Cesar Gil ANNUAL- PFE SERVICE Part# Description Required Already • se . TAMPER SEAL REPLACEMENT PER NFPA 10 I TAG, MONTHLY INSPECTION FIRE EXTINGUISHER", (For In- MONTHLYINS 11.00 11.00 1 0.00 House Monthly "Quick Check" I I v Inspections performed 4 Customer 110ABC 10lb ABC FIRE EXT. SERVICED i 4.00 4.00 i 0.00 _ _ __._. 15ABC 151b ABC FIRE EXT. SERVICED 7.00 7.00 0.00 Work Completed Notes Left fire extinguisher_spares(02) 101b ABC (05)51b ABC `Materials Used Location TAG, MONTHLY INSPECTION "FIRE EXTINGUISHER", (For In-House Monthly "Quick Check Inspections performed by Customer)- ANNUAL PULL PIN OPER. &TAMPER SEAL REPLACEMENT PER NFPA 10 .4.00 i 51b ABC FIRE EXT. SERVICED 7.00 4 101b ABC FIRE EXT. SERVICED 4.00 1 i i I i I I 3 1 I 1 i i v The above work has been completed to my complete satisfaction. Customer: Dante Cordova / f { i Print Name S:gr,ature I The above work has been completed according to the relevant NFPA&AHJ Standards. i i Technician: Cesar Gil Pdnt Name S� nature — ..----.__ _.._...._.__._............................._......_.............._.. g. Page 3/3 SYSTEM RECORD OF INSPECTION AND TESTING This Corm is ro be comp/etcio bx the system nx sagction arnd leshng cvntrvclor n:the rime otQ system te,f f!shatfbc p�rmiftedto moai4,this lomr as needed fo provtod a mote compiefe and or Gear veep d insert N/A zn anunused fines. Affach addlfionatsheets,data,or cakv1,q&ons as necessary fo prowoe a complete fewlLf lnspccri m'fest Start Date'llmc: 6/25/2024 Incxction%fr.t l'umpleuon I>arr'l tree: 6/2512024 Supplemental Fomu, lfached: iyc.:nw 1. PROPERTY INFORMATION Name _Rye Ridge Shopping Center- South Bldg. Addre,,: 1.58-204 S. Ridge Street Rye Brook, NY 10573 ncscriptionOfpntprrty- Retail Stores & Restaurants Name of pnrjxny represcruatise: 111tin Ridge Realty-Alena HakaIIiin _ ,cadre..: 24 Rye Ridge Plaza Phone: 914-701-4005 pay: L,mail. a akanjin,_ra nrid ge.eam 2. TESTING AND MONITORING INFORMATION fcetiag orpaitnion: Scarsdale Security Systems, Inc Address: 132 Montgomery Avenue.Scarsdale,NY 10583 Phone: (914)722-2200 fa.: (914)722-2299 E-mail: service(ct�.scarsdalesecuritv.com Monitoring urganiz:itiurt Scarsdale Security Systems Inc. I Addrea: 132 Montgomery Avenue Scarsdale, NY 10583 Phone: 914-722-2222 vas: F.marl: Account number: 541307 Plhrtte line 1: Phone tine'-. Means of transmission: Digital Enbn to%chich alanns are reuansmiucd: Phore: 3. DOCUMENTATION On-sac location of the required record doeunFenrs and site-spcortc soitwarc 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit Maaofncturer: Firelite Motel uumlxr. 4.2 Software and F'irm%are Fimmare resi*ion rrumher. 4.3 S,,stem Poser 43.1 Primary(Main)Power Nominal voltage: 120 Amps: 15 Location: Electrical Closet 0%murrem protection type: Amps: Dkconnc.ting means Itkition: copyNfit o 2012 Nab W tan Protscoon A"O=tion.Tiles Form mey oe c 1;rio for Wmduo use oew loan br resale.R mey roc oe cmied for mnwwcieF sate ot t tLson. t SYSTEM RECORD OF INSPECTION AND TESTING(continued) 4. DESCRIPTION OF SYSTEM OR SERVICE (continued) 43.2 Secondary Power Battery -- l.,x�t, _PZQEtI-_ -- Baticn 1MV til applicahlel: Lead Acid _.. ('alcutaled capacity rd hatleric�to drite the s%-ion In,tandhN sntstk Ihratra. 24 1n afann m,JL!unmutes': 10 5. NOTIFICATIONS MADE PRIOR TO TESTING \tnniwrinc a;can,sulnn t ont.let: Scarsdale Security Systems Inc. I tou: 10:00am Building management Conwct; Time: — Building occupants C"alact: Authority having jurisdiction Other,if OOutet: l ime. required 6. TESTING RESULTS 6.1 Control L nit and Related F.yuipmeat i Visual i Functional Description i Ins ctlon Test Comments Control unit I Pass Lam s/LEDs/LCDs P1 Pass t Fuses0 Trouble signals I C7 i Pass I Disconnect switches iPass Ground-fault monitoringi Pass Supervision OL/ M, Pass Local annunciator 91 � Pass Remote annunciators 2( Q( Pass Remote power panels G( Q� Pass Pass 6?Secondary Pother Visual Functional Descri tlon Inspection Test Comments Battery condition &� Pass Load voltage Q� Pass Discharge test 0 0 Charger test 0 0 Remote panel batteries 0 10 0p7yr,9M ti 2012 Nalor%ai Fxe Pwtect�Assoc otgrl This term may t> coped IN r.d WW)VSe CtY'Ma^.kW r,mwe !t may oot be csso-m for mmmeroai sae or dbss- SYSTEM RECORD OF INSPECTION AND TESTING(continued) 6. TESTING RESULTS(continued) 63 Alarm and Supervisory Alarm Initiating Device Attach supplementary device test sheets for all initiating devices. 6A Notification Appliances Attach supplementary appliance test sheets for all notification appliances. 6.5 interface Equipment Attach supplementary interface component test sheets for all interface components. Circuit Interface/Signaling Line Circuit Interface/Fire Alarm Control Interface 6A Supervising Station Monitoring Description Yes No Time Comments Alarm signal V ❑ 13:30 Pass Alarm restoration 0 15:00 pass Trouble signal 6( O 13:15 Pass Trouble restoration ® O 15:00 Pass Supervisory signal bd ❑ Pass Supervisory restoration ❑ 6.7 Public Emergency Alarm ReportingStislem Descri tlon Yes No Time Comments Alarm signal ❑ ❑ Alarm restoration ❑ O Trouble signal ❑ O Trouble restoration © ❑ Supervisory signal ❑ ❑ Supervisory restoration ❑ O COW ONO Z012 kCional Fee PIW^2on Asi06at ort.Tho 10fM MY be 0C9W 1U WUYI ual:ne OC t Pun la resale.01 mat nOt be CCOW fOf NnmeraSJ fain or dtcbQAon. SYSTEM RECORD OF INSPECTION AND TESTING(continued) 7. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: Scarsdale Security Systems Inc. Timc: 15:44pm Building management Contact: Timc: Building occupants Contact: Timc: Authority having jurisdiction Contact: Time: Other,if Contact l imc: required 8. SYSTEM RESTORED TO NORMAL OPERATION Date: 612512024 Timc 9. CERTIFICATION This system as specified herein has been inspected and tested according to NFPA 72, 2013 edition,Chapter 14. tiigttttl: Q.,/ � LyyLgyU Printed mune: John Fleischman late: 06/25/2024 Organizan n: Scarsdale Security Systems Tille. Fire Inspector _ Phone: 914-722-2222 Qualifications(refer to IOS.11: 10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING, OR MAINTENANCE Smokg Detector Front I older Level.l matt be replaced 7A W2024 Te "Cuin onstts 158-204 South Bldg,#3 Replaced 2 smone detedm,1 in vacaM space 204(Lower Level)and 1 in oto FJevafan eufgw,system nermat depaw 10.1 Acceptance bY Owner or Owner's Representative: The undersig eft accepted the test report for the system as specified herein: Signed: Printed name: .}r� Dale: J' 2 ` t} d,j, �g ;yt Organt2�tion:, �' "� 7 ��,'titic: �� r ,� �t�' Phunc: t}c- --s CovrVN 0 2012 rtauoiw Fro Amection Assooston Ws form nay be coped for n4a0uat tie oma Doan b(tasate.it may not oe tooted!or owwwcW two or Wsvout a. Inspection, Testing and Maintenance Form Wet Pipe Fire Sprinkler ALL��'�� Systems FIRE SPRINKLER SYSTEMS INC This form covers the minimum requirements of NFPA-25 2017 for wet pipe fire sprinkler systems connected to water supplies without tanks or fire pumps.Sepemte forms are available for fire pumps,tanks,hose connections,and other fire protection systems.More frequent inspection,testing and maintenance may be necessary depending on the conditions of the occupancy and the water supply. Property Name __ Date of Work South building(158-204 S.Ridge St) 09/14/2023 Address Phone 24 Rye Ridge Plaza 914-701.4005 City State Zip Code Property Contact Rye Brook NY 10573 jAiena Hakanim Owner Name Win Ridge Realty LI-C All responses refer to the current work performed on this dale. Inspection Type Weekly Monthly Quarterly Semiannual Annual 5-Year Notes 1)All questions are to be anwered Yes,No,or Not Applicable.AII'No answers are to be explained in Part ill of this form. 2)Inspection,Testing,and Maintenance tasks are to be performed with water supplies(including fire pumps)in service,unless the impairment procedures of Chapter 15 of NFPA 25 are followed. PART 1-Owners Section A.Is the building occupied? if.Has the occupancy and hazard of contents remained thesame since the last inspection?c select an option- I-select an option- C.Are all fire protection systems In service? 0.Has the system remained in serAce without modification since the last inspector? -select an option- -I select an option- I-Was the system free of actuation of devioes and alarms since the last inspection? -select an option- Owners Representative Date Atena Hakanjin 09/14/2023 signature r------------------------------- ------------------------------- n r n r n t r n n t n t r r r r n r r r r r n n n PART 2-Inspector's Section A.Inspections-Report any failures in Section III 1.Weekly inspection items a.Control Valves(including baddbw preventer isolation valves)supervised with seats passed b.Relief port on RPZ not discharging inspection as described in 111A.2.a) N/A Yes 2.Monthly inspection Items(in addition above Items) a.Control Valves and Valves on backflow preventers 1.In correct(open or dosed)position? 2.If not electrically supervised,locked in correct position? i Yes Yes 3.Accessible and free from visible leeks? 4.Provided with appropriate wrenches? Yes Yes 5.Provided with appropriate Identification? Yes b.Alarm valve free from physical damage,trim in correct(open or closed)position,and no leakage tram retarding chamber or drains? N/A 3.Quarterly Inspection items(In addition to above Items) Iof4 a.Gauges monitoring water pressure in good condition and showing normal water supply b.Fire department connections visible,accessible,couplings and swivels not damaged, pressure gaskets in place and in good condition,check valve not leaking,clapper In place and Ves I operating property,and operating drain valve in place and operating propedy.(If plugs or caps 1 are not In place,inspect for Interior obstructions) Yes i c.Control valves electrically supervised d.Alarm and supervisory devices not damaged? Yes _..._..__.._._� Yes e.Pressure reducing valve in open position,not leaking,with downstream pressure per design criteria and in good condition with hand wheels not broken? N/A 4.Annual Inspection(in addition to above items) a.Proper number and typeof spare sprinklers? t.List of spare sprinklers attached and legible Ves Yes -- i b.Visible Sprinklers 1.Proper position:Upright,pendent,sidewall? 2.Free of leaks,corrosion,damage? yes Ves 3.Proper clearance below sprinklers? A.Free of foreign material including paint? Yes i 5.Liquid in all gas bulb sprinklers? Yes c Visible Pipe r1.In good condition/no external corrosion? 2.No mechanical damageor leaks? I Yes Yes 3.No external loads? d.Visible pipe hangers/seismic bracing not loose or damaged? Yes yes 1 e_Sprinklerwrench(es)with spare sprinklers I.Genreal information sign attached and legible ) (yes 1 Yes g.Has the internal Inspection of pipe removing a flushing connection and one sprinkler head h.Hydraulic information sign securely attached to riser and legible? narthe end of a branch lime)performed in the last 5 years?if no,conduct internal inspection N/A N/A S.5-Year Inspection items(in addition to above items) a.Alarm valves and associated strainers,filters,and restricted orifices pawed internal b.Chak valves Intemalfy inspected,all parts operate and are In good condition inspection? N/A N/A c.Internal pipe inspection performed per iLAA.g N/A ---� B.Testing-Report any failures in Section III 1.Quarterly Testing Items a.Mechanical water flow alarm devices actuated and flow observed? b.Main drain test for system downstream of back-flow device or pressuring reducing valve? N/A yes 1.System static pressure(pal) 2.System residual pressure(pail l 10 (55 3.Was flow observed? 4.Are results comparable to previous tests? Yes Yes 2.Semiannual Testing Items(in addition to above items) a.Valve supervisory switches indicate movement? b.Electrical water flow alarm devices actuated and alarmed? yes yes 3.Annual Inspection items(In addition to above items) a.Main drain test(for system not tested quarterly) 1.System static pressure Cc" 2.System residual pressure(psi) 10 55 3.Was flow observed? 4.Are results comparable to previous tests? Yes yes b.Post indicating values opened until spring or torsion felt in the rod then closed back 1/4 a All Sprinklers manufactured after 1920? sum? ves N/A 2 of 4 d.Quick response sprinklers 20 years old or more replaced or successfully sample tested In the e.Standard response sprinklers 50 years old or more replaced or successfully sample tested in last 10 years? rthe last 10 years? N/A I NIA f.Standard response sprinkler:75 years or note replaced or successfully sample tested in the lllg.Dry-type sprinklers replaced or successfully sample tested in the last S years? last 5 years? N/A N/A h.Sprinklers subject to harsh environment replaced or successfully sample tested in the last 5 years? N/A i.Antifreeze solution specific gravity 1.Correct at most remote point? 2.Correct at interface with wet system? N/A j N/A 3.Correct st othertest points(over 150 gal) 4.Correct type of antifreeze? N/A N/A j.All control valves opersted through full range and returned to normal position? k.Bacdlow devices passed forward flow test? Yes N/A I.Pressure reducing valves passed partial flow test? r N/A — — lll4.5•Year Inspection Items(in addition to above items) a.Sprinklers above high temperature tested? b.Gauges checked by calibrated gauge or replaced? NIA ;rN/A c.Pressure reducing valves passed full flow test? till N/A C.Maintenance 1.Regular maintenance items a,If any sprinkler failed the sample testing of Pan 11.03 were all sprinklers represented by that b.Itsprinkla has been replaced,were they proper replacements? sample replaced? N/A N/A c.Marine systems normally having fresh water were drained and refilled twice if raw water got d.Heat tape Inspected per manufacturees instructions? into the system? F. N/A --.� e.If any of the following were discovered,was an obstruction investigation conducted?Explain reason(s)and findings in Part III 1.Defective intake screen on pump supplied from sources 2.obstructive material discharged during flow test N/A N/A 3.Foreign material in dry pipe valves,check valves or pumps 4.Foreign material in water during drake test or plugging of Inspectors test Connection N/A N/A 5.Plugging of pipe or sprinklers found during activation or work 6.Record of broken mains In vicinity N/A N/A 7.Abnormally frequent false-tripping of dry-pipe valves S.Failure to flush yard piping or surrounding mains following new Instaflatlon or repairs N/A N(A 9.System to returned to service after an extended period of time out of service(more then one 10.There is reason to believe the system contains sodium silicate or its dedvations or highly year)? corrosive fluxes In copper pipe N/A N(A 11.Raw water was pumped into the fire department connections 12.Pinhole leaks 1111 N!A N/A I.If conditions were found that required flushing,was flushing of system conducted? g.Was a valve status test connected after opening any closed valves? N/A N/A h.Adjusted,repaired,reconditioned or replaced components had the associated tests and/or inspections performed N/A 2.Annual Maintenance heirs(in addition to above Items) a.operatkg stem of all oSBY valves lubricated,completely dosed,and reopened? b.Sprinkles and spray nozzles protecting commercial cooking equipment and ventilating N/A systern replaced etatpt for bulb-type which shows no signs of grease buildup? N/A PART 3-Comments 3of4 Any'No answers,test failures or other problems found with the sprinkler system must be explained here.(Asa courtesy,note on a seperate form any concerns about anything that you saw while performing your work that is not apart of the NFPA 25 requirements including any recalled products that you happened to notice.) Comments PART 4-Inspectorts Information I state that the information on this is form correct at the time and place of my inspection,and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in Pan III above. Company Company Address all safe fire 375 Executive Blvd,Elmsford,NY Inspector Date Unification or License Number,If applicable SEAN BROWN 09/14/2023 Inspector Signature �_"'--------------------------- ------------------------------- t n i n t i n r i r r r n r Inspection performed in accordance with NFSA Standard for the Inspection Testing,and Maintenance of Water-Based Flee protection Systems,2017 edition. 4 of 4 \) ! � } , } ■ LL }7777 ) - /( • . 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Fischer David M.Heiser Salvatore W.Morlino March 18,2024 Via 1•t Class Certified Mail CVS c/o Mr.Matthew Breitenbecher,Facilities Program Manager,Retail Facilities One CVS Drive—Mail Code 1190 Woonsocket,Rhode Island 02895 Re: CVS,182 South Ridge Street,Rye Brook,New York 10573 Dear Mr.Matthew Breitenbecher,Facilities Program Manager,Retail Facilities, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection.Please note that you are required by Rye Brook Village Code§91-4.B,to undergo and successfully complete a Fire Inspection for this location at least every thirty six (36)months. In order to avoid a violation,please complete and submit the attached Fire Inspection/Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than, April 18,2024,which is thirty(30)days after the date of this notice.Please note that the property owner's notarized signature, as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three(3)years by filing a Fire Inspection/Operating Permit Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30)days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. %,-- 9 Steven E.Fews Building&Fire Inspector stevefewsta'l=brook.org cc:Alfredo DiVitto,Assistant Building& Fire Inspector Laura Petersen,Office Assistant Alena Hakanjin,Property Manager /to y 4 •,�aGb V„�V VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J.Bradbury www.1yebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R.Epstein Steven E.Fews Stephanie J.Fischer David M.Heiser Salvatore W.Morlino March 18,2024 Via Pt Class Mail CVS c/o Mr.Matthew Breitenbecher,Facilities Program Manager,Retail Facilities One CVS Drive—Mail Code 1190 Woonsocket,Rhode Islind 02895 Re: CVS, 182 South Ridge Street, Rye Brook,New York 10573 Dear Mr.Matthew Breitenbecher,Facilities Program Manager,Retail Facilities, It has come to the attention of the Building Department that it has been over three years since the premises located at the above captioned address has undergone and successfully completed a Fire Inspection.Please note that you are required by Rye Brook Village Code§91-4.B,to undergo and successfully complete a Fire Inspection for this location at least every thirty six (36) months. In order to avoid a violation,please complete and submit the attached Fire Inspection/Operating Permit Application form, remit the correct application fee,and schedule your triennial Fire Inspection with the Building Department by no later than, April 18,2024,which is thirty(30)days after the date of this notice.Please note that the property owner's notarized signature, as well as the business owner's notarized signature must appear on the application form in the appropriate spaces. Upon successful completion of the Fire Inspection,you will be issued a Fire Inspection Certificate valid for three(3)years. Please remember that you must schedule your Fire Inspection every three(3)years by filing a Fire Inspection/Operating Permit Application,remitting the applicable fee,and scheduling your Fire Inspection with the Building Department at least thirty(30)days prior to the expiration date listed on your Fire Inspection Certificate. Thank you. Steven E.Fews Building&Fire Inspector s teve fews011yebrook.org cc:Alfredo DiVitto,Assistant Building&Fire Inspector Laura Petersen,Office Assistant Alena Hakanjin,Property Manager /to