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BP24-256
rERMIT # ' ��� DATE: � � e3 ®(P SECTION i BLOCK / LOT TYPE OF WORK E' % �%� 10 B LOCAT N Q �- ! j � OWNER �C - / l __� 2 �iP ���� CONTRACTOR�� ��Gl%�oI%�O cS�OJu�D�I_C � i�c �ST. COST � FEE 0 # � FEE` ��� L� TCO # FEE DATE FOOTING FOUNDATION FRAMING RGH FRAMI INSULATION PLUMBING RGH PLUMB GAS SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT FINAL DATE 1 NSP // Ii%2c.{.1�jr' �'e S S �l,Ii %�o�oGc� �y���a-�s8� .v, y �1ctu� / C9�y)1/39- 3 �/03 OTHER APPROVALS ARB BOT PS ZBA OTHER FINISHED BASEMENT NOT APPROVED FOR USE AS A SEPARATE APARTMENT OR DWELLING UNIT N� - 7 - 2"OZ /lb>e �/ c�i� � � '�l /%�Q�! ��QS ��G1�1 f��/�y � �2Q7�/�i]C( LNG �-'�o-2oZS� �C��r-eSp;��,�/erSys�tirS\1`'�,C� �� ��„ �IIO�Oa� ,I a ,y��s-oa7/ c�iC (- 2oL IG� -_ -dS "/.S � Cf � �- � � � � / ��i �0 ��P L�J � �� � - 0 ��� 2�2� �s -� PAS—D�-7/�oc��C'o VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-048 Certificate of Occupancy This is to certify thatpau of, having duly filed an application on ~ / 20 6;;?5 requesting a Certificate of Occupancy for the premises known as, led C/Jy'ch�' , Rye Brook,NY, located in a Zoning District and shown on the most current Tax Map as Section: Block: Lot: -�5 and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No - , issued �p? 20 7 , such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications, Use: — Q �' / + Construction: for the following purposes: I :zp �f] 1' S Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: FINISHED BASEMENT , APPROVED FOR USE AS A SEPARATE APARTMENT OR DWELLING UNIT This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made, and no enlargement, whether by extending on any side or by increasing in he shall be ma or shall the building be moved from one location to another until a permit to accomplish such change has ee ob ed fr e Building Inspector. Building Inspector,Village of Rye Brook: Date: APR 10 2025 �yE DR Y 4r la Lc �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.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E.Fews David M.Heiser Donald T.Krom,Jr. Salvatore W.Morlino CERTIFICATE OF COMPLIANCE April 10,2025 Paul Goldberg&Leslie Goldberg 27 Legendary Circle Rye Brook,New York 10573 Re: 27 Legendary Circle,Rye Brook,New York 10573 Parcel ID#: 124.65-1-25 This document certifies that the work done under Mechanical Permit #25-047 issued on 3/31/2025 for the installation of new supply and ductwork for basement zone has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to ttQy�'BR(�k, . 19 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 David M. Heiser Donald T.Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE April 10,2025 Paul Goldberg&Leslie Goldberg 27 Legendary Circle Rye Brook,New York 10573 Re: 27 Legendary Circle, Rye Brook,New York 10573 Parcel ID#: 124.65-1-25 Mechanical Permit#25-027 issued on 2/28/2025 to Install Fire Sprinkler Heads This certifies that the fire sprinkler heads,installed under the above captioned permit,have been satisfactorily completed. Sincerely, 199; Steven E. Fews Building&Fire Inspector /to Q BUILDING DEPARTMENT For office use onl : �s PERMIT# 3 56 VILLAGE OF RYE BROOK ISSUED: DD APR - 3 2025 �38 KING STREET,RYE BROOK,NEW YORK 10573 DATE: i (914)939-0668 FEE: 4 /�tj-Cj — PAM IL VILLAGE OF RYE BROOK www.ryebrookny.201*' BUILDING DEPARTMENT 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 }f#t#i#####}t#ii}#iiikifi ikikkiii#kt##f##fi##4f#tf######k}##}##t#}tt}#i#f kfftt##tftff#i#f##i}iiiitk#kff#fifff##}##iif}ii#ik#i Address: 27 Legendary Circle Rye Brook NY 10573 n Occupancv /Use: / ,�/L! Parcel ID#: f a y j & 5 j — D S Zone: /"L/ owner: Paul & Leslie Goldberg Address: 27 Legendary Circle Rye Brook NY 105573 P.E./R.A. or Contractor: 4�7 '--V 1tkf T-1-C Address: -:3> 6- IV0-4 U L4//V'6 jq/XS /Vr'-' Person in responsible charge: t )ay Address: Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law: STATE OF NEW YORK, COUNTY OF WESTCHESTER as: Paul Goldberg being duly swom,deposes and says that he/she resides at 27 Legendary Circle (Print Name of Applicant) (\o.and Street) in Rye Brook in the County of Westchester in the State of NY that (Ch, Tocsn 1 illuge) he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all 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:$_)Q O 0 0 -- for the construction or altcration of: / t t / l 29Qhoe 4 7/ S`je tQ!�� SelWP/I A CS('PSS lit )/1 OCC/ Deponent further states that he/she has examined 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,converted or enlarged,wholly or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per§250-IO.A. of the Code of the Village of Rye Brook. Sworn to before me this 03 Sworn to before me this day of k--� , 20 day of , 20 vo lkltll\ Si ature o perty Owner Signature of Applicant ctyl ame of Property Owner Print Name of Applicant i Notary Publi§HARI MEULLO Notary Public Notary Public,State of New York No.OIME6160063 Qualified In Westchester County Commission Expires January 29.20 �yE BRC�� uJ � 1932 BUILDING DEPARTMENT ❑/BUILDING INSPECTOR II ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : z / P !s 12 DATE: PERMIT# 13�' L y S� ISSUED: 2-/'-? 'SECT: y16 BLOCK: LOT: ' LOCATION: T� 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 ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER F\ L.C J L C G U ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER QyE BRC�k• cu � • 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 : Z h(o DATE: PERMIT# '" ' Z`5 ISSUED: SECT: IZ`/- 6; BLOCK: LOT: Z LOCATION: A&..er'\o OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... B'ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION �� S 1 ! ^ Aa.'e ❑ NATURAL GAS r �l (" ❑ L.P. GAS --t" �� �w Z �► �l ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER �E BRC��• 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: DATE: PERMIT# Z S ' D 7 ISSUED: SECT: BLOCK: LOT: LOCATION: + J �^-� / \ �� O� ¢ S J l� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... Er--ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING f ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRCS"- Q�i F o 1 1932 BUILDING DEPARTMENT ❑BUILDING INSPECTOR �QASSISTANT 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: 7 r�02 PERMIT# Z-5 O�LZ ISSUED: SECT: BLOCK: LOT: LOCATION: ',!q M,f 3� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... .0 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 QyE BRCbk_ O�` tim BUILDING DEPARTMENT ❑BUILDING INSPECTOR E 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 : L4_1 4 - .1 cI C��1 - .�_. DATE: - / - 2 02,S PERMIT# rn Z Z 7 ISSUED: SECT: _ BLOCK:LOT: 2 LOCATION: J OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑Y 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 �J ❑ FUEL TANK ❑ FIRE SPRINKLER �- ❑ FINAL PLUMBING ❑ CROSS CONNECTION Lam? y �� j ' 4, U v ❑ FINAL ❑ OTHER QyE BRC�,�. 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 : Q� ,L nS 'pU (A:,✓�h BCD DATE: Z - 3 0 - .2u o2 Q L� / PERMIT# F\ 2 � V I L7 ISSUED: SECT: �� b BLOCK: LOT: �� LOCATION: 'J Q 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 f ❑ NATURAL GAS /,G ` ' ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �yE BRC�k, w � 0` BUILDING DEPARTMENT LDING 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 V DATE: zz PERMIT#S�2 ISSUED: Z SECT: BLOCK: LOT: LOCATION: ���S�a OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS...,,,O 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 ;t � w ° Ln N N = N c N �'. � � w M+1 rT O W x cn a N �d cn o. ■ ZW a+ Z n x a a v _ v rjj •q .c ^^�. ■. M t, 14 aCN W x � � o x 3 •.. " � v � Q Q z � F � c �j z � a oc GO a� v o ' as C) IOU m � oMU. z C7 W p ° v i � � a : BUILKET ` } t ENT D V VILYEOK 938 KING BRNY 10573 NQV - s 202-0aks VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: Approval Date: ! _ / mi c�'/� Application# Approval Signature: 4K, W ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: 0- -A Permit Fees: X 2 EXTERIOR BUILDING PERMIT APPLICATION Application dated: — ) ! is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. I. JobAddress: �lCC�'t T� grirI /[ 1j S-7 2. ParcelID#: , Zone: �[ 3. Proposed Improvement(Describe in detail): ran w Rye OtX C A rr c f-f- &0 e 4. Property Owner: O Address: Ze-—7 ek ems- IYc C Phone#lt /Y /57C cmit e-mail FFd%Aeri 7W L' rm'l(vm List All Other Properties Owned in Rye Brook: Applicant: Address: Phone# Cell# e-mail Architect: Address: Phone# Cell# e-mail Engineer: Address: Phone# Cell# e-mail General Contractor. 'Uto rvlvhDkf 4C . Address: 36 (r✓ L'�1 p a Phone# Cell# 7/7 y3,!35'©3 e-mail X".*nyn41!4«�(),14k.611 (1} b/1/2024 5. Occupancy;(I-Fam..2-Fam..Commercial-etc...)Pre-con struction:_r Jr7t h Post-construction:--L�:i_�#rt 6. Area of lot: Square feet: +/- 8520 Acres: +/- 0.1956 7. Dimensions from proposed building or structure to lot lines: front yard: No Change rear yard: NO Change right side yard: No Change _left side vard: No Change_ other: 8. If building is located on a corner lot,which street does it front on: NA exlstln 9. Area of-p;epess�building in square feet: Basement:+"/-1 420 1 fl;+/-1 420 2^d fl: +/-1,420 Yd fi: NA 10. Total Square Footage of the proposed new construction: No new construction _ 11. For additions,total square footage added: Basement: NA 1, fl: NA _2r"fl: NA 3`d fl: NA 12. Total Square Footage of the proposed renovation to the existing structure:. Finished Basement: +/-960 sq.ft. 13. N.Y. State Construction Classification: V N.Y.State Use Classification: R-3 14. Number of stories: TWO Overall Height: NO Change Median Height: No Change 15. Basement to be full, or partial: Full , finished or unfinished: Finished _. 16. What material is the exterior finish:_ Vinyl Siding (No Change) 17. Roof style;peaked,hip, mansard,shed,etc: Gable (No Change) Roofing material: Asphalt Shingle 18. What system of heating: NO Change (No Change) 19. If private sewage disposal is necessary,approval by the Westchester County Health 'Department must be submitted with this application. 20. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system? (Fire Sprinkler,ANSL System, FM-200 System,Type 1 Hood,etc...) Yes: No:, (if yes,applicant must submit a separate,Automatic Fire Suppression System Permit application&2 sets of detailed engineered plansi 21. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft. or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: ',X_Area: 22. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes, No:_� lif yes.applicant must submit a Site Plan Application,&provide detailed drawings) 23. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (jves,you must submit a Site Plan.Application, &provide a detailed topographical survey) 24. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: (if yes, the area of wetland and the wetland buffer zone must be properly depicted on the survev&site plan) 25. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes : No: (if ves, the area and elevations of the flood plane must be properh'depicted on the survey&site plan) 26. Will the proposed project require a Tree Removal Permit as per§235 of Village Code? Yes: No: (ifyes,applicant must submit a Tree Removal Permit.Application) 27. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No:_.2S,_ Indicate: TIER V. TIER 11: TIER III: (ifyes, a Home 0pahon Permit Application is required) 28. List all zoning variances granted or denied for the subject property: 29. What is the total estimated cost of construction: $ U i Note.The estimated cost shall include all site improvements.labor,material,scaffolding,fixed equipment,professional fees, including any material and labor which may be donated gratis, tf the final cost exceeds the estimate cost.a additionat fee will be required prior to issuance of the C,0_ 30. Estimated date of completion:____ 2 n� (2) 6/1 t2024 BUILD.)14#_ 69PAR. 'MENT D VILL�'(E OF R=RF,NY OOK NOV _ 6 2024 938 KugG STET RYE 10573 (914)939-066 VILLAGE OF RYE BROOK roo '•20V 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: I, PA L41 61 ,residing at, A�-0-161 dA L iUe (Print name) (Address My ere you live) 60 being duly sworn, deposes and states Ut(s)he is the applicant above named,and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; �T l" N , Rye Brook,NY. (Job Addics 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. (Signature of Pr( ,crly Owner(s)) I Print Namc of roperry Omicr(s)) Sworn to before me this day of 20� (Notary PubljcQ Notary f': „m York Commission Expire:, J/gi�a (2) 1 6/1/2024 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. Please note that application fees are non-refundable. STAT F NE\ Y RK TY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (print a of individual signing as the applic t) and further statphat;{I�)he is t legal owner of the property to which this application pertains, or that (s)he is the �,✓ t f°� 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 Eire Prevention & Building Code, the Code of the Village of Rye Brook and all other applicable laws, ordinances and regulations. By signing this application, the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this 011 Sworn to before me this Z } �{ day of A&z k"]�v� , 20 ` day of n/ 20� f , :4K / Si ure of Pro erty caner Si ure of Applica u� TG Print Name'of Property Owner Print Name of Appli t Notary Public Notary Publ ELIZABETH A DREAPER JAMES G. STRIAR N Notary Pubic, �?r,tc of New York NOTARY PUBLIC.STATE OF NEW YORK No. 8�-�-�"j'1' C�s�'6t5dN12 Registration No.OIDR6177050 C]ualified in Westchestalr COUnty Qualified in Westchester County Commission Expires&s El6 l �l Commission Expires January 11,2028 (4) 6/I/2024 ' ������w��Ti��•'�•'�• •w�w�w Vw Vw�.�w���M���w����1����i��i��R�S���Y�w \� \'�i��i���� F,�w i r �11 N Oi N N N N pL = = a N N O F W ^ u x .� s u , ar Ln 00 obe p x w 00 x O H > �Lr) ^./ Q U Ncq F A a/ A Ln o u, °°ell cn e I.-, � O 00 oo A \ a a 7 Z p M w z uo Z � A M Z Q c > ^ V s a Z � Q a W :. cy w l�r z g U `! i- z � o q w z oA : iiJi iist * i�6T;Tf +d�r 44 s 4R /iw iw i3 1 3 G BUILDING DEPARTMENT DD VILLAGE OF RYE BROOK R F AN 2 7:02:5 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.ryebrookn\.jjov_ BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required 11 FOR OFFICE USE ONLY BP#: �� — L5 co EP#: �S--Dd y Approval Date: t 2� Permit Fee: $ 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 7—�S is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of Application dated, /— 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.L Address: SBL: 124 S — 1 —Z15- Zone: Pu� 2.Property Owner: ow Address: V-t LZC1a✓0CLr!:f Phone#: Cell#: q li-{ - �'}2-Lf58� email:Q5g01��,�oG.t�q�]:11 ®gr�at.l J� 3.Master Electrician/Licensed(Installer: '�J- r-%C, TAAO-,t-`Q Address: J L FJ ECr%4 P-6C t tQ1U4✓ Lic.#:1543 Phone#:ILA •biYLQ480e11#: cSAW.-L-- email: Ph DMa►r asI2C rt���►�10.31 .C�v+ Company Name: 1 t�C) &Q.t.'f+'tG tA(!�, • Address: l5 ��p6�Gc�' �`►G� yql �� �-{ 4.Proposed Electrical Work/Fixture Count: tp5�S S,w.,o t-'e %r C-C DG{ec o W t re Gow 5.3rd Party Electrical Inspection A S 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) state that(s)he is the 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 to before me this day of 120 day of 20Q_ Signature of Property Owner Signature of Applicant Print Name of Property Owner P ' f i me of Applicant Notary Public Notar l tP*WW of Now Yolk No.01M8MOM 6/1/2024 Qualified In VA*tphestK County2 commission Explros lemusry 29,40 3 STATE WIDE INSPECTION SERVICES, INC. CAO Service Willi Integrity 0•• • • SWIS JOB APPLICATION •. • Office Use Elect. Permit# Date -7 �:i, � Bldg Permit# Scl Ft Plumbing Permit# Final Certificate# City/Village Zip Building Dept. County Address Cross Street Section Block Lot Owner Name/Address(if different than above) Contact Number ❑Basement ❑ 1st Fl. ❑ 2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms 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 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 ID JAN 2 7 2025 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 Name License# Date Signature Address City/State Zip Code Company Phone# Dr w F State Wide Inspection Services 1080 Main Street Fishkihkill, NY 12524 TOWUS FEB 12 2025 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: office@swisny.com Service With integrity BUILDING DEPARTMENT Website: www.swisny.com —�---- BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Pineiro Electric Inc Paul Goldberg Eric Pineiro 27 Legendary Circle 115 Prospect Avenue Rye Brook, NY 10573 Valhalla, NY 10595 Located at: 27 Legendary Circle, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP25-024 124.65 1 25 Certificate Number: 2025-0768 Building Permit Number: BP24-256 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: 27 Legendary Circle, Rye Brook, NY 10573 The Basement 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 5"' Day of February 2025. Name Quantity Rating Circuit Type Receptacles 20 Luminaires 12 Switches 10 GFCI 04 Smoke Detectors 03 C/O Detectors 03 A Visual Inspection of existing conditions was performed on February 51 2025 of the Basement and Conforms to NFPA 70-2017 NEC. No Defects Were Noted. 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 a v N V_ C C WN M L 04 i • •' N cq14 W • a 0 H a k O c h w W U W g A W eG ■ r. O C*4 co 00 O O 070IWO ■. V zGN • ~ � ~ r 7 W W a MW = 1! W a ■ a w z H F z Z c �► H a Ln Z8 w ¢ W OF Ln 4641 tU0446 46 �S��i Tit5itW�lii C; iw 7i Bii iTi i4i Ctj a $Atj41to & 14ataVia41 y _b_R p BUIjE EPAR,TMENTDD VIL OF RYE800K JAN 2 8 2025938 KINET RYE BILK,NY 10573 VILLAGE OF RYE BROOK wij9 �okrlyo`, BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP #: PP#: C=a� Approval Date: 2� 'Z Permit Fee: $ Approval Signature: 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 Application dated, 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 Plumbing 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: 2 � `fir( �c SBL: ,: L/, S J— 2.Proposed Work: j `� �O1 G W� 3.Property Owner: `I�' !f ddress: /� Phone#: I�,.! \Ceell#: 1`1 T)Z ,r� email: 4.Master Plumber: S 1 U I X� Addrers(s:r: � � tic, Lic.#: 04 9t Phho #• 200 Cell ( T?4 5 email: t �^/ Company Name: rC � Q UVI� �!Y\ � �'A dress: a� 13Y0J 1 INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement y 1 st Floor 1 I 2nd Floor 3rd Floor 01 Floor 5m Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -I- 6/l/2024 UIL MEN BVMla0v OK T D LE C IE � " E 938 KINGNY 10573 JAN Z 8 2025 VILLAGE OF RYE BROOK **B UI�4J *.QW 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: / J, Ead6�11119?1_1 , residing at, �7 ��,y Cl rG`e (Print name) (Address w1lere 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 property to which this Affidavit of Compliance pertains at; 7 C11c, 4- Rye Brook,NY. (Job Address) 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. (Signature of Prope t) Owncr R V5—. d/ (Print Name ofProperty Owner(s)) Sworn to before me this L day of 20 2,5 e �4==_ (Notary Public) ,.. -., ,. CTRIAq Nlcf-rY Yr). ,,, k +� -3- 6/1/2024 • STATE OF NEW YOR XO,11J�TY OF WESTCHESTER ) as: ,, C�.t!' ,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 7�C(4'� Sworn to before me this day of Nci kI vc—q ,20 day of ���ti���, ,20 J-�r SigAature of1koperty Owner Signature of Applicant veivl 3- r1(1d1141-'e7-- oe�w axk\A� Print Name' of Property Owner Print Name of Applicant - ,V,- 4e, Notary Pu is 10NAMA n Notary Public-State of New York Y,),k No.OIME6362617 -� oZS-t(,is;�'�'m- Qualified in Westchester County M Comm.Expires Aug.7,2025 l�y��Z7 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. 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 s� ■' 6 A ' Lr; ° ►l� N N W c � si QI N N y �.•1 \ \ v e"a O y. 0-4 3 w h k f C r e N ■ p. W +n r1 v K A 3 z v _ F :J 1+ ° w° f•' ` \ CL W rW7 /FrY'Y F YM W, V Q, ACA z cl� V +, OC G1 a �4 u rN V v z 7 v v E f w O f o Ln �•� Qj DD BUILD MENT VIL E OF RYE OOK FEB 2 6 2025 938 KING ET RYE BRO NY 10573 4 -0661ff VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT APPLICATION TO INSTALL FIRE SUPPRESSION /FIRE SPRINKLER SYSTEM FOR OFFICE USE ONLY: Approval Date:FEB 2 8 P#: Q '01 MP#: c;),5— a Application Fee:$ 0 Approval Signature: Permit Fees:$ 15c) Disapproved: Other: Application dated: �, Vj- S is hereby made to the Building Inspector of the Village of Rye Brook NY for the issuance of a Permit to install or modify a Fire Suppression/Fire Sprinkler System as per detailed statement described below. 1. Job Address: 2. Parcel I.D.: /p� , Zone: T U� 3. Proposed Work(Describe system in detail including suppression agent): k t'N,0, r-- 4. Number&Types of Fire Sprinkler Heads: T 5. N.Y State Construction Classification: N.Y.State Use Classification: 6. Estimated Value of Job:$ '' ,[0D 0- Do (Value shall include all labor,materials,fixed equipment,professional fees,and materials and labor which may be donated gratis.)"" 7. Property Owner: At Address: Phone# Cell# vjq 7 2p 9 email: 8. Architect/Engineer: Address: Phone# P Cell# email: -� 9. Sprinkler Contractor: 1 �P S' . ddress:�� �Q 6.4 , l,, /MJ q . Phone#9/`� �7q 5 ( J Cell# i i q / 7LI S / U email NLS �n t 6/1/2024 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. Please note that application fees are non-refundable. STAT&F NW RK' z,— OF WESTCHESTER ) as: 0 YQ A ,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 Sprinkler 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 , 20 day of \_ F b(L�Q� 1 , 20 c) Signature of Property Owner Signan of Applicant A Print Name of Property Owner ame of Applicant Notary Public Notary Public SHARI MEULLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester county commission Expires Jendary 29,20 z_1 2 b/l/2024 t co Wo"W".� Cr-,nla6te ww'w tYt43 hre Series TY-FRB, 5.6 K-factor Upright, Pendent, and Recessed Pendent Sprinklers Quick Response, Standard Coverage 1MPQRIANT war. ta'Gzhri.i Cu..'q Ir. sN.o3ytYS fCe�r-,dw..,,, SFaMh1Qr USlS- n -� •rn ' for y wrt br'.- .-JalOr Ald hear_r^ a „.r., • A iw*-v#e# 'S" - 14w .rsY3 rotor to re. Ectulflvon•Arta raeeSi#d ad"T r01 TfFr'170 lur r rriam up to&4 on. 11 S.9 mmt hom , _ harsh pert tirrear.r� `• AIG-Mat Ow. '"rospect tO t`andkn 4and • A tvto-ptec* Sts4# 70 Ft"*,%%#d ,. Esculchoon wtth Iec4mod adtuat. - r-wrt up 10 117 it II;T mtirij Mgm Tt)# adluslm#nt prov'ded by tha Fwessed lscutct►eoR +educes ttse WCuec-t tO vs•%Oc 1"1 Iced ptV*&C" to the spfrailers MAP be cut k-,tetrne•date k.al mi")ns of Ser-" TY-FAR >•* i)*ut*trd fr% Fecfwwar DvA Sr aw MP}37 Ww6 i M.let guards and melds are des4f'bo! w Tor ,"fia LWa;r.inw TFP:bG ,to a 77re ;Y(;O Ssnes TY Mg Sennwt" ��. r�. d"Cr;bed Aaron MvW b# +ns,t#►*d ` J *^d ma ntauter3 nn cY,rr pri.tce Wpm this ducatrw+t as sod' as w1M It* • {f• at.�LrlcaG:r staM'ards rN the Ntboriu' Fear PraMcht r-A"o-r a me.M**,$tow pAatlmum W o-king Pressure ��s � '� to the btarrldrds or�r Ottw^dO w =W.I V41 .•� t tws 0%yo 7 nets lic ton Fart ee to do so FS4 p,s t+'2 car ._• r'-wr P#-kw-w"C#of"0* •Ka.w,.w...i.,•:w-«... ss:... Y L,�ffl'.•'7_7 ORNCO.! ,,•.wa,..+w.r.,.s.,a i........,-_y. .e..,. `JJJ;,,,,,,���J •a•� YhO owrN►r is raipeMe*" for misn- tam,rg tr+o.r Ne probrnat system Discharge CoeHlcsent arm deuces if-,PrVO •wwatmv car- •.'Sd rsPtA.•per 1!Q#tj'it't+ar,� fs±eut fr>r�t►s':r tnw.ntsR4ng r. t•mc- Tat�peratwe RatMrq tar of PI-o&or#.�a.,'.-ter"wVT am►' S"Yet-0 General qxVAcw'S A.rl Description »T +-� Sprinkler 4 K tac'tcu, 4�• ,',:t;'.v=.-.u.:-i1-ar�uen!ITY3231 Identification tNu'it~nawdGaeM•^•ita♦.•Q.terl9rans grnl�descry In Ifft date sneer are arm nworoo.etarda-d C~apa. Number (SIN) doe, rathme 3 min gifts bulb r6e sprxt stlrrN Ws dea+gt»d rw u%*in plot or T i 313. l.prlyf+t 5 t:�. 1 in yN T ...•�•+• aaaa.C::{it+r Ort3rwrY+taurd,come-wC.-al oca:uparr- T"23 Pof rlt—1 R R% 117 ire NPT S.•ryy ass• aW tv.ars.sesw F'[xtzYs Ca#b atxr+a!tiafllltl.hOteit.and Sl'a:W.. C-�:�wcc.«t-nlr n•;,..tv � s Technical Sri:• The r vO vwsiur *0 Me SwvosData YY FR@ Perratnt $.anklet, rrhara apokabW,is tnAs Mded for use rn areas Approvals Sol`:a%.-c A ft"I of 4 SEPTEMBEn 2022 >)�j Worldwide www.tyco-fire.com ® Contacts Series TY-B and TY-FRB Poly-Stainless Sprinklers IMPORTANT TY-FRB Series Refer to Technical Data Sheet • 3 mm diameter heat sensitive glass bulb TFP2300 for warnings pertaining to . Quick response(QR) rating regulatory and health information. i Although corrosion resistant sprinklers Always refer to Technical Data have passed the standard corrosion tests o ] t Sheet TFP700 for the 'INSTALLER '� f the applicable approval agen- ,A WARNING" that provides cautions t � cies, the testing is not representative with respect to handling and instal- of all possible corrosive atmospheres. lation of sprinkler systems and com- Consequently, it is recommended that ponents. Improper handling and the end user be consulted with respect installation can permanently damage to the suitability of this coating material a sprinkler system or its compo- for any given corrosive environment. nents and cause the sprinkler to fail The effects of ambient temperature, to operate in a fire situation or cause concentration of chemicals, and gas/ it to operate prematurely. chemical velocity, should be consid- ered,at a minimum,along with the cor- Scan the QR code or enter the URL rosive nature of the chemical to which will be exposed. in a web browser to access the most the sprinklers up-to-date electronic version of this Upright and Pendent Sprinklers document. Data rates may apply. The upright and pendent sprinklers are standard coverage spray sprinklers - a available in either 5.6 or 8.0 K-factor. The recessed version is intended for use in areas with a finished ceiling. J The two-piece Style 10 (112 inch NPT) tection Association, in addition to the or Style 40 (3/4 inch NPT) recessed escutcheons provide 1/2 inch (12,7 standards of any authorities having mm)of recessed adjustment or 3/4 inch Jurisdiction.Failure to do so may impair ■1 the performance of these devices. • (19,1 mm) of total adjustment from the flush pendent position.The adjustment The owner is responsible for main- taining their fire protection system reduces the accuracy to which the fixed and devices in proper operating con- pipe drops to the sprinklers must be dition. Contact the installing contrac- cut, for or product manufacturer with any docs.jci.com/tycofire/tfp682 Horizontal Sidewall Sprinklers questions. The horizontal sidewall sprinklers are Sprinkler General designed for installation along a wall p or side of il beam and just beneath a Identification Description smooth ceiling.Sidewall sprinklers are commonly used instead of upright and Number (SIN) The TYCO Series TY-B and TY-FRB pendent sprinklers due to aesthetics or Poly-Stainless Sprinklers are corrosion building construction considerations, TY-B Standard Response desirable. Upright resistant sprinklers designed for use in where piping across the ceiling is not TY3151 an U n ht 5.6K, 1/2 in. NPT commercial occupancies where corro- in. NPT /.6K,TY3251 . . .Pendent 5 12 sive atmospheres may exist. A recessed version of the horizon- TY4151 . . . Upright .OK, 1/2 in. NPT The series characteristics are as tal sidewall sprinkler can be achieved TY4251 . . .Pendent 8.OK, 3/4 in. NPT follows: by using the Style 10 recessed escutcheon. TY3351 . . . . .HSW*5.6K, 1/2 in. NPT TY-B Series TY-FRB Quick Response • 5 mm diameter heat sensitive glass VOT17"73 TY3131 . . . Upright 5.6K, 1/2 in. NPT bulb • Standard response(SR) rating The Series TY-B and TY-FRB Sprinklers TY3231 . . .Pendent 5.6K, 1/2 in. NPT described herein must be installed TY4131 . . . Upright 8.OK, 3/4 in. NPT and maintained in compliance with TY4231 . . .Pendent 8.OK,3/4 in. NPT this document and with the applica- TY3331. . . . .HSW*5.6K, 1/2 in. NPT ble standards of the National Fire Pro- =Horizontal Sidewall Page 1 of 10 AUGUST 2022 TFP682 TFP682 Page 2 of 10 Model Bulb Sprinkler K-Factor Type Temperature Liquid Material Response Rating Color Brass 135'F(57°C) Orange Upright 155°F(68°C) Red TY3151 175°F(79°C) Yellow and Pendent 200'F(93°C) Green TY-B TY3251 286°F(141°C) Blue 5.6 360°F(182°C) Mauve 1/2 in.NPT SR 135'F(57°C) Orange Recessed' 155°F(68°C) Red Pendent TY3251 175'F(79°C) Yellow See Figure 1 200°F(93°C) Green 286-F(141°C) Blue 1,2,3 135°F(57°C) Orange Upright 155°F(68°C) Red TY4151 175°F(79°C) Yellow and Pendent 200'F(93°C) Green TY-B TY4251 286°F(141°C) Blue 8.0 3/4 in.NPT 360°F(182°C) Mauve SR 135'F(57°C) Orange Recessed" 155'F(68°C) Red Pendent TY4251 175'F(79°C) Yellow See Figure 1 200'F(93°C) Green 286°F(141'C) Blue NOTES: 1. LIL Listed 2. C-LIL Listed 3. EAC Approved Installed with Style 10(1/2 NPT)Recessed Escutcheon •'Installed with Style 40(3/4 NPT)Recessed Escutcheon TABLE A POLY-STAINLESS SERIES TY-B STANDARD RESPONSE 5.6 AND 8.0 K-FACTOR UPRIGHT AND PENDENT SPRINKLERS LABORATORY LISTINGS AND APPROVALS Physical Characteristics Technical Frame .............. Polyester coated Brass Operation Button................ L316 Stainless Steel' Data Compression Screw..... L316 Stainless Steel The glass bulb contains a fluid which Bulb...............................Glass expands when exposed to heat.When Approvals Deflector...................Copper/Bronze the rated temperature is reached, the UL and C-UL Listed Sealing Assembly.Gold Plated Beryllium Nickel fluid expands sufficiently to shatter the EAC Approved w/TEFLON" glass bulb, allowing the sprinkler to 1603 Note:For complete approvals information, A479/479Mor BS EN 1008 WN1ainless steel(LINS34404'per ASTM activate and water to flow. see Tables A,B,and C. **Beryllium Nickel(LINS N03360)Gold Plated per MIL Maximum Working Pressure 7 G-45204,Type 3,Class 2. Design 175 psi(12,1 bar) Criteria Temperature Rating See Tables A, B, C,and D The TYCO Series TY-B and TY-FRB Sprinklers are intended for fire protec- tion systems designed in accordance with the standard installation rules recognized by the applicable Listing or Approval agency-for example,the L L Listing is based on the requirements of NFPA 13. Only the Style 10 or 40 Recessed Escutcheon, as applicable, is to be used for recessed installation. TFP682 Page 3 of 10 Model Bulb Sprinkler K-Factor Type Temperature Liquid Material Response Rating Color Brass 135°F(57°C) Orange Upright 155°F(68°C) Red TY3131 and 175°F(79°C) Yellow Pendent TY3231 200°F(93°C) Green TY-FRB 5.6 286-F(141°C) Blue 112 in. NPT 135°F(57°C) Orange QR _ Recessed 155°F(68°C) Red Pendent" TY3231 175°F(79°C) Yellow See Figure 2 200°F(93°C) Green 286°F(141°C) Blue 135°F(57°C) Orange 1,2,3 Upright 155°F(68°C) Red TY4131 and 175°F(79°C) Yellow Pendent TY4231 200°F(93°C) Green TY-FRB 8.0 286°F(141°C) Blue 3/4 in. NPT 135°F(57°C) Orange QR Recessed 155°F(68°C) Red Pendent" TY4231 175°F(79°C) Yellow See Figure 4 200°F(93°C) Green 286°F(141°C) Blue NOTES: 1. UL Listed 2. C-UL Listed 3. EAC Approved Installed with Style 10(1/2 NPT)Recessed Escutcheon '•Installed with Style 40(3/4 NPT)Recessed Escutcheon TABLE B POLY-STAINLESS SERIES TY-FRB QUICK RESPONSE 5.6 AND 8.0 K-FACTOR UPRIGHT AND PENDENT SPRINKLERS LABORATORY LISTINGS AND APPROVALS .TFP682 Page 4 of 10 Model Bulb Sprinkler K Factor Type Temperature Liquid Material Response Rating Color Brass 135°F(57°C) Orange 155°F(68°C) Red Horizontal 175°F(79°C) Yellow Sidewall TY3351 200°F(93°C) Green TY-B 286°F(141°C) Blue 5.6 1/2 in.NPT 360°F(182°C) Mauve SR 135°F(57°C) Orange Recessed Horizontal 155°F(68°C) Red Sidewall` 175°F(79°C) Yellow TY3351 200°F(93°C) Green See Figure 5 286°F(141°C) Blue 1,2,3 135°F(57°C) Orange 155°F(68°C) Red Horizontal Sidewall 175°F(79°C) Yellow TY3331 200°F(93°C) Green TY-FRB 5.6 286°F(141°C) Blue 112 in. NPT 135°F(57°C) Orange OR Recessed Horizontal 155°F(68°C) Red Sidewall` TY3331 175°F(79°C) Yellow See Figure 6 200°F(93°C) Green 286°F(141°C) Blue NOTES: 1. UL Listed 2. C-UL Listed 1 EAC Approved Installed with Stvle 10(112 NPT)Recessed Escutcheon TABLE C POLY-STAINLESS SERIES TY-B STANDARD RESPONSE AND POLY-STAINLESS SERIES TY-FRB QUICK RESPONSE 5.6 K-FACTOR HORIZONTAL SIDEWALL SPRINKLERS LABORATORY LISTINGS AND APPROVALS TFP682 Page 5 of 10 WRENCH 1/2" ESCUTCHEON 1 - Frame 3 - Sealing 5 Compression *Temperature FLATS NPT PLATE SEATING 2 - Button Assembly Screw rating indicated tRFACE 4 - Bulb 6 - Deflector* on Deflector. 1 7/16" 3 (11,1 mm) NOMINAL2-3/16" ��2 MAKE-IN (55,6 mm) 4 2-3/16° 1/2"(55,6 mm) mm) 5 6* STYLE 10 -- 2-7/8" (73,0 mm)DIA. RECESSED UPRIGHT PENDENT ESCUTCHEON RECESSED PENDENT CROSS SECTION FIGURE 1 POLY-STAINLESS SERIES TY-B STANDARD RESPONSE UPRIGHT(TY3151)AND PENDENT(TY3251)5.6 K-FACTOR 112 INCH NPT SPRINKLERS WRENCH 112" ESCUTCHEON 1 Frame 3 - Sealing 5 - Compression *Temperature FLATS NPT PLATE SEATING 2 - Button Assembly Screw rating indicated \ SURFACE 4 - Bulb 6 - Deflector* on Deflector. 1 7/16" 3 (11,1 r NOMINAL 2-3/16" 2 MAKE-IN (55,6 mm) 2-3/16" 1-112" 4 (55,6 mm) (38,1 mm) 1::::: 5 6* STYLE 10 2-7/8"(73,0 mm)DIA. - RECESSED UPRIGHT PENDENT ESCUTCHEON RECESSED PENDENT CROSS SECTION FIGURE 2 POLY-STAINLESS SERIES TY-FRB QUICK RESPONSE UPRIGHT(TY3131)AND PENDENT(TY3231)5.6 K-FACTOR 112 INCH NPT SPRINKLERS WRENCH 3/4" ESCUTCHEON 1 Frame 3 - Sealing 5 - Compression *Temperature FLATS NPT PLATE SEATING 2 Button Assembly Screw rating indicated SURFACE 4 - Bulb 6 - Deflector* on Deflector. 1 112" = 3 (12,7 r JNOMINAL MAKE-IN 2-5/16" 2 (58,7 mm) 2-1/4" 4 1-9/16" (57,2 mm) (39,7 mm) -5 6* STYLE 40 2-7/8"(73,0 mm)DIA. - RECESSED UPRIGHT PENDENT ESCUTCHEON RECESSED PENDENT CROSS SECTION FIGURE 3 POLY-STAINLESS SERIES TY-B STANDARD RESPONSE UPRIGHT(TY4151)AND PENDENT(TY4251)8.0 K-FACTOR 314 INCH NPT SPRINKLERS TFP682 Page 6 of 10 WRENCH 3/4" ESCUTCHEON 1 Frame 3 Sealing 5 Compression *Temperature FLATS NPT PLATE SEATING 2 Button Assembly Screw rating indicated SURFACE 4 Bulb 6 - Deflector* on Deflector. 1 112" 3 NOMINAL NO MAKE-IN 2-5/16" 2 (58,7 mm) 2-1/4" 1-9/16" 4 (57,2 mm) (39,7 mm) f 5 6* STYLE 40 2-7/8"(73,0 mm)DIA. -- RECESSED UPRIGHT PENDENT ESCUTCHEON RECESSED PENDENT CROSS SECTION FIGURE 4 POLY-STAINLESS SERIES TY-FRB QUICK RESPONSE UPRIGHT(TY4131)AND PENDENT(TY4231)8.0 K-FACTOR 314 INCH NPT SPRINKLERS 1 - Frame DEFLECTOR Installation 2 Button HAT 5 The TYCO Series TY-B and TY-FRB 3 - Sealing sprinklers must be installed in accor- Assembly dance with this section. 4 - Bulb General Instructions 5 - Compression Do not install any bulb type sprinkler Screw if the bulb is cracked or there is a loss 6 - Deflector* 6* 4 2 3 1 of liquid from the bulb. With the sprin- kler held horizontally,a small air bubble 9/16" WRENCH 112" should be present.The diameter of the (14,3 mm) FLATS NPT air bubble is approximately 1/16 inch I (1,6 mm)for the 135°F (57°C) and 3/32 inch (2,4 mm) for the 360°F (182°C) temperature ratings. A 112 inch NPT sprinkler joint should be obtained with a minimum to maximum torque of 7 to 14 ft-Ibs(9,5 to 19,0 Nm). A 3/4 inch NPT sprinkler joint should be 1-13/16" 7/16" obtained with a minimum to maximum �_(46,0 mm) (11,1 mm) y torque of 10 to 20 ft-Ibs (13,4 to 26,8 CENTERLINE NOMINAL Nm).Higher levels of torque may distort OF SPRINKLER MAKE-IN the sprinkler inlet and cause leakage or WATERWAY 1-1/2" impairment of the sprinkler. �(38,1 mm) Do not attempt to compensate for ESCUTCHEON insufficient adjustment in the sprinkler PLATE SEATING 2-3/16" by under- or over-tightening the sprin- SURFACE (55,6 mm) kler.Re-adjust the position of the sprin- kler fitting to suit. STYLE O RECESS 10 ED ESCUTCHEON *Temperature rating is indicated on Deflector 2-7/8" DIA. (73,0 mm) 1 FIGURE 5 POLY-STAINLESS SERIES TY-B STANDARD RESPONSE HORIZONTAL SIDEWALL (TY3351)5.6 K-FACTOR 112 INCH NPT SPRINKLERS TFP682 Page 7 of 10 Upright and Pendent Sprinklers The Poly-Stainless Series TY-B and DEFLECTOR TY-FRB Upright and Pendent Sprin- 1 Frame HAT 5 klers must be installed in accordance 2 - Button with the following instructions: 3 Sealing Assembly Step 1A. Upright sprinklers must be 4 - Bulb installed in the upright position, and 5 - Compression pendent sprinklers are to be installed Screw in the pendent position. 6 - Deflector* Step 2A. With pipe thread sealant 6 4 2 3 1 applied to the pipe threads, hand tighten the sprinkler into the sprinkler 9/i m WRENCH NPT fitting. (14,3 mm) FLATS Step 3A.Tighten the sprinkler into the I sprinkler fitting using only the W-Type 6 Sprinkler Wrench, refer to Figure 10. With reference to Figures 1,2,3,and 4, apply the W-Type 6 Sprinkler Wrench to the sprinkler wrench flats. Recessed Pendent Sprinklers 1-13/16" 7/16" The Poly-Stainless Series TY-B and �_(46,0 mm) (11,1 mm) TY-FRB Recessed Pendent Sprinklers CENTERLINE NOMINAL must be installed in accordance with OF SPRINKLER MAKE-IN the following instructions: WATERWAY 1-1/2" Step 16. After installing the Style 10 (38,1 mm) or 40 Mounting Plate, as applicable, ESCUTCHEON over the sprinkler threads and with PLATE SEATING 2-3/16" pipe sealant applied to the sprinkler SURFACE (55,6 mm) threads,hand tighten the sprinkler into the sprinkler fitting. STYLE 10 Step 2B.Tighten the sprinkler into the RECESSED sprinkler fitting using only the W-Type ESCUTCHEON 7 Recessed Sprinkler Wrench, refer to Figure 11. With reference to Figures *Temperature rating is 1, 2, 3, and 4 apply the W-Type 7 indicated on Deflector Recessed Sprinkler Wrench to the sprinkler wrench flats. Step 3B. After the ceiling has been installed or the finish coat has been 2-718" DIA. applied,slide the Style 10 or 40 Closure (73,0 mm) over the sprinkler and push the Closure over the Mounting Plate until it comes in contact with the ceiling mounting surface. FIGURE 6 Horizontal Sidewall Sprinklers POLY-STAINLESS SERIES TY-FRB QUICK RESPONSE HORIZONTAL The Poly-Stainless Series TY-B and SIDEWALL (TY3331)5.6 K-FACTOR 112 INCH NPT SPRINKLERS TY-FRB Horizontal Sprinklers must be installed in accordance with the follow- Recessed Horizontal Sidewall Step 3E.Tighten the sprinkler into the ing instructions: Sprinklers sprinkler fitting using only the W-Type Step iC. Horizontal sprinklers must The Poly-Stainless Series TY-B and 7 Recessed Sprinkler Wrench, refer to be positioned in the horizontal position TY-FRB Recessed Horizontal Sidewall Figure 11.Apply the W-Type 7 Sprinkler with their centerline of waterway per- Sprinklers must be installed in accor- Wrench to the wrench flats shown in pendicular to the back wall and parallel dance with the following instructions: Figure 5 and Figure 6. to the ceiling. The word "TOP" on the Step 1E. Recessed horizontal sidewall Step 4E. After the wall has been deflector is to face towards the ceiling. sprinklers are to be positioned in the installed or the finish coat has been Step 2C. With pipe thread sealant horizontal position with their centerline applied,slide the Style 10 Closure over applied to the sprinkler threads, hand of waterway perpendicular to the back the sprinkler and push the Closure over tighten the sprinkler into the sprinkler wall and parallel to the ceiling. The the Mounting Plate until it comes in fitting. word "TOP" on the deflector is to face contact with the wall mounting surface. Step 3C.Tighten the sprinkler into the towards the ceiling. sprinkler fitting using only the W-Type Step 2E. After installing the Style 10 6 Sprinkler Wrench,as shown in Figure Mounting Plate over the sprinkler 10. Apply the W-Type 6 Sprinkler threads and with pipe thread sealant Wrench to the wrench flats shown in applied to the sprinkler threads, hand Figure 5 and Figure 6. tighten the sprinkler into the sprinkler fitting. .TFP682 Page 8 of 10 2-7/8" DIA. 2-7/8" DIA. ) 5/8t1/4"5/8t1/4" 19,1 mm (73,0 mm) 3/4"( (73,0 mm) 3/4"(19,1 mm) (15,9t6,4 mm) 2-1/4"DIA. 1/4"(6,4 mm) (15,9t6,4 mm) 2-1/4" DIA. 114"(6,4 mm) FACE OF (57,2 mm) MOUNTING FACE OF (57,2 mm) MOUNTING SPRINKLER PLATE SPRINKLER PLATE FITTING FITTING / 1/8" 1/8" (3,2 mm) (3,2 mm) MOUNTING MOUNTING SURFACE SURFACE CLOSURE TY3231 or 1-1/4"(31,8 mm) CLOSURE TY4231 or 1-5/16"(33,3 mm) TY3251 3/4"(19,1 mm) TY4251 13/16"(20,6 mm) FIGURE 7 FIGURE 8 POLY-STAINLESS SERIES TY-B OR TY-FRB POLY-STAINLESS SERIES TY-B OR TY-FRB RECESSED PENDENT 5.6 K-FACTOR 112 INCH NPT RECESSED PENDENT 8.0 K-FACTOR 314 INCH NPT SPRINKLER ASSEMBLY SPRINKLER ASSEMBLY WITH TWO-PIECE 314 INCH TOTAL ADJUSTMENT WITH TWO-PIECE 314 INCH TOTAL ADJUSTMENT STYLE 10 RECESSED ESCUTCHEON STYLE 40 RECESSED ESCUTCHEON 5/8t 1/4" (15,9t6,4 mm) /s \ MOUNTING FACE OF WRENCH RECESS SURFACE SPRINKLER (END"A" USED FOR FITTING / 112" NPT MODELS) CLOSURE WRENCH RECESS (END"B"USED FOR 2-7/8" DIA. 3/4" NPT MODELS) TY3331 or (73,0 mm) FIGURE 10 TY3351 2-1/4"DIA. W-TYPE 6 SPRINKLER WRENCH (57,2 mm) WRENCH MOUNTING RECESS PLATE \�Y 1/8" (3,2 mm) 1-1/4"(31,8 mm) 3/4"(19,1 mm) 3/4"(19,1 mm) 1/4"(6,4 mm) FIGURE 9 PUSH WRENCH POLY-STAINLESS SERIES TY-B OR TY-FRB IN TO ENSURE RECESSED HORIZONTAL SIDEWALL ENGAGEMENT 5.6 K-FACTOR 112 INCH NPT WITH SPRINKLER SPRINKLER ASSEMBLY WRENCHING AREA WITH TWO-PIECE 314 INCH TOTAL ADJUSTMENT FIGURE 11 STYLE 10 RECESSED ESCUTCHEON W-TYPE 7 SPRINKLER WRENCH .TFP682 Page 9 of 10 Care and P/N 57 - XXX - X - XXX Maintenance The TYCO Series TY-B and TY-FRB Sprinklers must be maintained and ser- viced in accordance with this section. Standard Response(SR) SIN Temperature Rating Before closing a fire protection system 570 TY-B 5.6K Upright SR TY3151 135 135°F(57°C) main control valve for maintenance work on the fire protection system that 590 TY-B 8.OK Upright SR TY4151 155 155°F(68°C) it controls,permission to shut down the 571 TY-B 5.6K Pendent SR TY3251 175 175°F(79°C) affected fire protection system must be 591 TY-B 8.OK Pendent SR TY4251 200 200°F(93°C) obtained from the proper authorities and all personnel who may be affected 578 TY-B 5.6K HSW SR TY3351 286 286°F(141°C) by this action must be notified. 360 360°F(182'l The owner must assure that the sprin- klers are not used for hanging of any objects; otherwise, non-operation in 370 TY-FRB 5.6K Upright QR TY3131 the event of a fire or inadvertent oper- 390 TY-FRB 8.OK Upright QR TY4131 Sprinkler Finish ation may result. 2 Grey Aluminium(RAL9007) 371 TY-FRB 5.6K Pendent OR TY3231 Absence of an escutcheon, which is used to cover a clearance hole, may 391 TY-FRB 8.OK Pendent QR TY4231 delay the time to sprinkler operation in 378 TY-FRB 5.6K HSW QR TY3331 a fire situation. Sprinklers that are found to be leaking TABLE D POLY-STAINLESS SERIES TY-B AND TY-FRB or exhibiting visible signs of corrosion UPRIGHT, PENDENT AND HORIZONTAL SIDEWALL SPRINKLERS must be replaced. PART NUMBER SELECTION Automatic sprinklers must never be painted, plated, coated or other- Thereafter,annual inspections accord- Limited wise altered after leaving the factory. ing to NFPA 25 should suffice;however, Modified sprinklers must be replaced. instead of inspecting from the floor Warranty Sprinklers that have been exposed to level, a random sampling of close-up corrosive products of combustion, but visual inspections should be made, so For warranty terms and conditions,visit have not operated,should be replaced as to better determine the exact sprin- www.tyco-fire.com. if they cannot be completely cleaned kler condition and the long term integ- by wiping the sprinkler with a cloth or rity of the corrosion resistant material Ordering by brushing it with a soft bristle brush. of construction, as it may be affected Care must be exercised to avoid by the corrosive conditions present. Procedure damage to the sprinklers before, The owner is responsible for the during, and after installation. Sprin- inspection,testing,and maintenance of Contact your local distributor for klers damaged by dropping, striking, their fire protection system and devices availability. When placing an order, wrench twist/slippage,or the like,must in compliance with this document, as indicate the full product name and Part be replaced.Also, replace any sprinkler well as with the applicable standards Number(P/N). that has a cracked bulb or that has lost of the National Fire Protection Associ- Sprinkler Assemblies liquid from its bulb. For more informa- ation such as NFPA 25, in addition to Specify: (specify SIN), (specify Stan- tion, see the Installation section. the standards of any other authorities dard Response or Quick Response), Frequent visual inspections are rec- having jurisdiction.Contact the install- (specify K-factor), (specify) tempera- ommended to be initially performed ing contractor or product manufacturer ture rating, (specify Upright, Pendent for corrosion resistant sprinklers, after with any questions. or HSW), P/N (specify from Table D) the installation has been completed, Automatic sprinkler systems should be Recessed Escutcheon to verify the integrity of the corrosion inspected,tested,and maintained by a Specify: Style (specify 10 or 40) resistant material of construction. qualified Inspection Service in accor- Recessed Escutcheon,Grey Aluminum dance with local requirements and/or (RAL9007)finish, P/N (specify') national codes. 'Refer to Technical Data Sheet TFP770. Sprinkler Wrench Specify: W-Type 6 Sprinkler Wrench, P/N 56-000-6-387 Specify:W-Type 7 Recessed Sprinkler Wrench, P/N 56-850-4-001 .TFP682 Page 10 of 10 1467 Elmwood Avenue,Cranston,RI 02910 1 Telephone a1-401-781-8220 02022 Johnson Controls.All rights reserved.All specification.and other Information show um n wars current as of docent—Won date and are subject to change without notice. Johnson 000 NATIONAL FIRE PROTKTION ASSOC—ON—NFPA ere rsgleternd trade+yrt�of Wtbnel Fae Protection A.socl.lbn; Controls IEFLCN Is s heda,nsrt of The Che�noure C—pe FC I LC CO® Worldwide www.tyco-fire.com Contacts Series RFII — 5.6 K-factor "Royal Flush 1111 Concealed Pendent Sprinklers Quick & Standard Response, Standard Coverage IMPORTANT • Allows installation of the sprinklers and pressure testing of the fire pro- Refer to Technical Data Sheet tection system prior to installation of TFP2300 for warnings pertaining to a suspended ceiling or application of regulatory and health information. the finish coating to a fixed ceiling. Always refer to Technical Data Sheet TFP700 for the "INSTALLER • Permits the removal of suspended / WARNING" that provides cautions ceiling panels for access to building 1.11 with respect to handling and instal- service equipment without having j lation of sprinkler systems and com- to first shut down the fire protection �C ponents. Improper handling and system and remove sprinklers. installation can permanently damage • Provides for 1/2 in. (12,7 mm)of ver- a sprinkler system or its compo- tical adjustment to allow a measure nents and cause the sprinkler to fail of flexibility in determining the length to operate in a fire situation or cause of fixed piping to cut for the sprinkler it to operate prematurely. drops. The Series RFII Sprinklers are shipped Scan the OR code or enter the URL With a disposable protective cap. The Sprinkler in a web browser to access the most protective cap is temporarily removed up-to-date electronic version of this during installation and replaced to help Identification document. Data rates may apply. protect the sprinkler during ceiling y pp y' installation or finish.The tip of the pro- tective cap can be used to mark the center of the ceiling hole into plaster TY3531 — 3 mm bulb board or ceiling tiles by gently pushing TY3551 — 5 mm bulb the ceiling product against the pro- tective cap. When ceiling installa- tion is complete, the protective cap is removed and the cover plate/retainer Data assembly is installed. ■ As an option,the Series RFII Standard Sprinkler Approvals ■ ■ Response(5-mm bulb)"Royal Flush II" Approvals apply only to the service ■ Concealed Pendent Sprinklers can be conditions indicated in the Design Criteria fitted with a silicone air and dust seal as section. shown in Figure 5. The air and dusts- . TY3531 (3 mm Bulb)is UL Listed, docs.jci.com/tycofire/tfpl81 seal is intended for sensitive areas C-UL Listed and NYC Approved where it is desirable to prevent air and (MEA 353-01-E)as Quick Response. dust from the area above the ceiling to . TY3531 (3 mm Bulb)is EAC Approved General pass through the cover plate. and VdS Approved(Certificate No. Description ® G4090007). • TY3531 (3 mm Bulb)is FM and The TYCO Series RFII 5.6 K-factor, The Series RFII Concealed Pendent LPCB Approved(Ref. No.094a/10)as "Royal Flush II" Concealed Pendent Sprinklers described herein must be Standard Response. Sprinklers Quick Response 3-mm installed and maintained in compliance p p ( with this document and with the appl- Note:FM and LPCB do not approve bulb) and Standard Response (5-mm concealed sprinklers for quick bulb), are decorative sprinklers fea- cable standards of the NATIONAL FIRE response. turing a flat cover plate designed to PROTECTION ASSOCIATION (NFPA), conceal the sprinkler.These sprinklers in addition to the standards of any TY3551 (5 mm Bulb)is UL Listed,C-UL are optimal for architecturally sensi- authorities having jurisdiction. Failure Listed, EAC Approved,FM Approved, tive areas such as hotel lobbies, office to do so may impair the performance LPCB Approved(Ref. No.094a/9),and buildings, churches,and restaurants. of these devices. NYC Approved(MEA 353 01-E)as The owner is responsible for maintain- Standard Response. Each sprinkler includes a cover plate/ ing their fire protection system and Approvals for Air and Dust Seal retainer assembly and a sprinkler/ devices in proper operating condition. UL and C-UL Listed for use with the RFII support cup assembly.The separable, The installing contractor or sprinkler Standard Response Concealed Sprinkler two-piece assembly design provides manufacturer should be contacted with (TY3551) the following benefits: any questions. Page 1 of 4 AUGUST 2022 TFP181 .TFP181 Page 2 of 4 Maximum Working Pressure 1/2" NPT SEALING Maximum 250 psi(17,3 bar)by UL, ASSEMBLY C-UL,and NYC / Maximum 175 psi(12,1 bar)by FM,VdS, and LPCB FRAME Temperature Rating CAP 155°F(68°C)Sprinkler with 139°F(59°C)Cover Plate 200°F(93°C)Sprinkler with SUPPORT 165°F(74°C)Cover Plate CUP WITH I ( BULB ROLL FORMED Discharge Coefficient THREADS K=5.6 GPM/psi112(80,6 LPM/bar"2) Adjustment I I COMPRESSION 112 in.(12,7 mm) SCREW Finishes GUIDE See the Ordering Procedure section. PINS(2) I I Physical Characteristics DEFLECTOR Frame ............................Bronze Support Cup...................Plated Steel (DROPPED Guide Pins.................. Stainless Steel DEFLECTOR I I — ' POSITION) Deflector..........................Bronze -z-r ----t-r Compression Screw..................Brass Bulb...............................Glass SPRINKLER/SUPPORT CUP Cap.....................Bronze or Copper I ASSEMBLY Sealing Assembly..Beryllium Nickel w/TEFLON Cover Plate.........................Brass THREAD INTO RETAINER Retainer............................Brass Ejection Spring.............. Stainless Steel SUPPORT WITH THREAD CUP UNTIL O O L DIMPLES Design MOUNTING SURFACE IS EJECTION FLUSH WITH SPRING Criteria CEILING The TYCO Series RFII 5.6 K-factor, "Royal Flush II" Concealed Pendent Sprinklers are intended for fire protec- tion systems designed in accordance with the standard installation rules SOLDER --- COVER recognized by the applicable Listing TABS(3) COVER PLATE/RETAINER PLATE or Approval agency; for example, LIL ASSEMBLY Listing is based on NFPA 13 and VdS FIGURE 1 Approval is based on the CEA 4001. MODEL RFII CONCEALED SPRINKLER For more information on LPCB and VdS ASSEMBLY Approvals, contact Johnson Controls at the following office: Operation Installation Enschede, Netherlands Telephone: 31-53-428-4444 When exposed to heat from a fire, The TYCO Series RFII 5.6 K-factor, Fax: 31-53-428-3377 the cover plate, normally soldered to "Royal Flush II" Concealed Pendent the retainer at three points, falls away Sprinklers must be installed in accor- The Series RFII Concealed Pendent to expose the sprinkler/support cup dance with this section. Sprinklers are only listed and approved assembly. with the Series RFII Concealed Cover General Instructions Plates having a factory applied finish. The deflector — supported by the Do not install any bulb-type sprin- guide pins — then drops down to its kler if the bulb is cracked or there is operational position. a loss of liquid from the bulb. With the The glass bulb contains a fluid that sprinkler held horizontally, a small air Do not use the Series RFII in applica- bubble should be present. The diam- tions where the air pressure above the expands when exposed to heat.When eter of the air bubble is approximately ceiling is greater than that below. Down the rated temperature is reached, the eter in. (1,6 r bubble for the 155°F lately drafts through the sprinkler/support fluid expands sufficiently to shatter the and 3/. ( in. m) mm) for the 200°F cup assembly can delay sprinkler oper- glass bulb, activating the sprinkler and and 3 temperature ratings. ation in a fire situation. allowing water to flow. A leak-tight 1/2 in. NPT sprinkler joint should be obtained by applying a minimum to maximum torque of 7 ft-lb to 14 ft-lb(9,5 N•m to 19,0 N•m).Higher levels of torque can distort the sprin- kler Inlet with consequent leakage or impairment of the sprinkler. TFP181 Page 3 of 4 FACE OF CLEARANCE HOLE CLEARANCE SPRINKLER - DIAMETER FITTING DIMENSION C SPRINKLER SUPPORT CUP ASSEMBLY 1/2"(12,7 mm) THREADED D ADJUSTMENT FACE OF CEILING, RETAINING RING MOUNTING FIGURE 4 SURFACE DISPOSABLE PROTECTIVE CAP Do not attempt to compensate for insufficient adjustment in the sprinkler i by under- or over-tightening the sprin- L _ kler/support cup assembly. Re-adjust 7�T -r the position of the sprinkler fitting to 3/16"to 11/16" MANUFACTURER DEFLECTOR COVER PLATE suit. (4,8 to 17,5 mm) PRESET GAP IN DROPPED RETAINER REFERENCE 3/32"(2,4 mm) POSITION ASSEMBLY Step 1. Install the sprinkler only in the pendent position with the center-line of the sprinkler perpendicular to the COVER PLATE COVER PLATE mounting surface. - PROFILE DEPTH --- DIAMETER -- - --- Ste 2. Remove the protective ca DIMENSION B DIMENSION A P P P• A:3-1/4 in.(82,6 mm) C:2-3/8 to 2-5/8 in.(60,3 to 66,7 mm) Step 3. With pipe thread sealant applied to the pipe threads, hand- B:3/16 in.(4,8 mm) D: 1-3/4 to 2-1/4 in.(44,5 to 57,2 mm) tighten the sprinkler into the sprinkler fitting. FIGURE Step 4. Wrench-tighten the sprinkler SERIES CONCEALED SPRINKLER INSTALLATION DIMENSIONS I using only the RFII Sprinkler Wrench. as shown in Figure 3.Apply the wrench to the sprinkler as shown in Figure 3. Step 5. Replace the protective cap by pushing it upwards until it bottoms FRAME out against the support cup as shown ARM � in Figure 4. The protective cap helps prevent damage to the deflector and arms during ceiling installation and/or SUPPORT finish. You can also use the protective CUP cap to locate the center of the clear- ance hole by gently pushing the ceiling material up against the center point of the protective cap. 7/8"(23 mm) As long as the protective cap remains SQUARE in place, the system is considered"Out of Service". ALIGN- -� Step 6. After the ceiling has been � \� completed with the 2-112 in. (63,5 mm) ARROWS WITH � diameter clearance hole and in prep- FRAME ARMS -�> aration for installing the cover late/ F retainer assembly, remove and discard ACCEPTS the protective cap. Verify that the O 112"SOCKET deflector moves up and down freely. DRIVE If the sprinkler is damaged and the FIGURE 3 deflector does not move up and down RFII SPRINKLER WRENCH freely, replace the entire sprinkler. Do not attempt to modify or repair a damaged sprinkler. Step 7.When installing an air and dust Seal, see Figure 5 for reference and TFP181 Page 4 of 4 SUPPORT SPRINKLER FACE OF ORIENT ASSOCIATION such as NFPA 25, in CUP CEILING -as— SEAL addition to the standards of any other BEVEL AS authorities having jurisdiction.Contact \ SHOWN the installing contractor or sprinkler COVER manufacturer regarding any questions. PLATE Automatic sprinkler systems should be RETAINER inspected, tested, and maintained by ASSEMBLY a qualified inspection service in accor- dance with local requirements and/or national code. AND DUST Limited LIP OF COVER SEAL RETAINER PLATE Warranty FIGURE 5 For warranty terms and conditions,visit OPTIONAL AIR AND DUST SEAL FOR SERIES RFII(TY3551) www.tyco-fire.com. follow this step; otherwise, proceed to installation, ensure that the new paint ordering Step 8.To attach the air and dust seal, does not seal off any of the air gap. verify the angle of the outside edge of Do not pull the cover plate relative to Procedure the seal is oriented according to Figure the enclosure. separation may result. 5. Start the edge of the retainer in the Contact your local distributor for grooved slot of the air and dust seal Sprinklers which are found to be availability. When placing an order, and continue around the retainer until leaking or exhibiting visible signs of indicate the full product name. the entire air and dust seal is engaged. corrosion must be replaced. Step 8. Screw on the cover plate/ Automatic sprinklers must never be Sprinkler/Support Cup Assembly retainer assembly until the retainer, painted, plated, coated, or other- Specify: Series RFII (specify SIN), shown in Figure 2, or the air and dust wise altered after leaving the factory. K=5.6, "Royal Flush II" Pendent Sprin- seal, shown in Figure 5, contacts the Modified sprinklers must be replaced. klers(specify)temperature rating, P/N' ceiling. Do not continue to screw on Sprinklers that have been exposed to (specify): the cover plate/retainer assembly so corrosive products of combustion, but 155°F(68eC) 200-F(93°C) that it lifts a ceiling panel out of its have not operated,should be replaced TY3531 51-792-1-155 51-792-1-200 normal position. If you cannot engage if they cannot be completely cleaned TY3551 51-790-1-155 51-790-1-200 the cover plate/retainer assembly with by wiping the sprinkler with a cloth or the support cup or you cannot engage by brushing it with a soft bristle brush. Use Suffix x I"for ISO 7-1 connection;for example, the cover plate/retainer assembly suf- ficiently to contact the ceiling,you must Care must be exercised to avoid Separately Ordered Cover Plate/ reposition the sprinkler fitting. damage to the sprinklers - before, Retainer Assembly: during, and after installation. Sprin- Specify: (temperature rating from Care and klers damaged by dropping, striking, below) Series RFII Concealed Cover wrench twist/slippage,or the like,must Plate with(finish), P/N (specify). Maintenance be replaced. Also, replace any sprin- 139°F(59°C)(a) 165°F(74 kler that has a cracked bulb or that has lost liquid from its bulb. For informa- G to (RAL9 The TYCO Series RFII 5.6 K-factor, q (RAL9002).... 56-792-0-135 56-792-0-165 "Royal Flush II" Concealed Pendent tion about replacing a sprinkler,see the Brushed Brass.. 56-792-1-135 56-792-1-165 Sprinklers must be maintained and Installation Section. Brass.......... 56-792-2-135 56-792-2-165 serviced in accordance with this Exercise care to avoid damage to sprin- Pure White(c) section. klers before, during, and after instal- (RAL9010) .... 56-792-3-135 56-792-3-165 Before closing a fire protection system lation. Replace sprinklers damaged Signal (RAL90 ii3).... 56-792-4-135 56-792-4-165 te main control valve for maintenance by dropping, striking, wrench twist- Jet Black work on the fire protection system ing wrench slipping, or the like. Also, (RAL9005)....56-792-6-135 56-792-6-165 that it controls, obtain permission to replace any sprinkler that has a cracked Terra Brown shut down the affected fire protection bulb or that has lost liquid from its bulb. (RAL8028) ....56-792-7-135 56-792-7-165 system from the proper authorities For information about replacing a sprin- Brushed kler,see the Installation section. Chrome........ 56-792-8-135 56-792-8-165 and notify all personnel who may be Chrome........ 56-792-9-135 56-792-9-165 affected by this action. If you must remove a sprinkler, do not Custom........ 56-792-x-135 56-792-X-165 Absence of the cover plate/retainer reinstall it or a replacement without NOTES reinstalling the cover plate/retainer assembly can delay sprinkler opera- a. For use with 155°F(68°C)sprinklers. tion in a fire situation. assembly. If a cover plate/retainer b. For use with 200°F(93°C)sprinklers. assembly becomes dislodged during c. Eastern Hemisphere sales only. When properly installed, there is a service, replace it immediately. Sprinkler Wrench nominal 3/32 in. (2,4 mm) air gap The owner is responsible for the Specify: RFII Sprinkler Wrench, between the lip of the cover plate and inspection,testing,and maintenance of P/N 56-000-1-075 the ceiling, as shown in Figure 2. their fire protection system and devices This air gap is necessary for proper in compliance with this document, as Air and Dust Seal operation of the sprinkler. If the ceiling well as with the applicable standards Specify:Air and Dust Seal, requires repainting after sprinkler of the NATIONAL FIRE PROTECTION P/N 56-908-1-001 1467 Elmwood Avenue,Cranston,HI 029101 Telephone a1-401-781-8220 4R, 0 2022 Johnson Cordroin.All N sown ghle reserved.All specifications and other Information h were current as of document ree i—data end are subject to change without notice. )oh1^soI a�1 NATIONAL FIRE PROTECTION ASSOCIATION and NIPA pre t� raplslered IreoemaMs of Netronel Fire Protection Azzecalon. Controls IF emp FI ON ea tredar,ak of The Chun Company FC.LLC 1, 1 it y • 0 N O {� � C a = N _ M M CC v W vNi W =n 3 ; Q Au 00 LL $ C v C Er w A w = ? � ` T 00 + r � ►-r ~ M U x � z 'Irl "V w uj U p5 � uorc E �x CE +_ I�•I ,� + R, A Q eV z 7 w 0 Q Q O CQ Z og U U cz, aa � w . N z w � z � � A •� gam• A R z A a a U k a � + •y � G � ► ► i �I it'd tat 44wUt4�4U too-01C4 Q 4;44TJ4;C044 to4 4*6#A41446 4 BMDIId-DErAR MENT V GE OF RYE��OOK ECEN E 938 KING kiREET RYE BROOK,NY 10573 (914) 9-06�,8 MAR 2 6 2025 www-rvArooknvxoy VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/ VE HEATING, VENTILATION AND/OR AIR CONDITIONING EOWMEN—T7 FOR OFFICE USE ONLY: Z/ Sty PERMIT#: /`7�o�-� / Approval Date: AP"�) 50 Permit Fee: $ / Approval Signature: ?du _ Other: 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. '/.%%%%R%R%%%%%%'/C%%'k�"A•*�'*'k'kR%%%%%%R%%%%%*%%%%%%%*%%%%*%%%%%%%%%%%tf%%%%%%%%%**%%%%%%%'iC%1'e%%%%%fie%%%%%% Application dated, 3,2,7• 2 S is 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: L c n c SBL: is y,CDC—k c�LSZone: 0"6 2. Property Owner: W-W O / Address: Phone#: q Y ' S b Cell#: email: �1° °k b�r9 I ' ` •C0� 3. Contractor: Qoq Q,I C C)m +O(+ Address: -7 d aUkflra M 1�t/`Q I bft G IAGW' Phone#:o 1,q)b q q- �6 C�o Cell#: — email: QOW Comii;rt Ny i a S-73 4. Scope of Work:New Installation( )•Replacement( )•Removal( )•Other&):Odd l;Nq tf�- Opn lAi l• Coo , 5. List Equipment: 1 v R' odd f+Mn-a) ZoY}2 6. Location of Equipment: S2p t 7. Method of Installation/Removal(list all equ'7t needed to perform ) i ,'iAi&l l 1'Y�(k-iLA n i (�► Zoin-e c Qn SU / l °` Men �dhe STATE OF NE�V 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. Sworn to before me this ;LJ Sworn to before me this 2-0 day of r� ,20_7&_ day of ► lad 202_ Si nature of P perty Owner Signature of Applicant P 'n ame f Pro erty Owner Print me of Applicant Notary--Public o lic FNOTARY RACE A.KEANE BLIC,STATE OF NEW YORKation No.02KE6424070 FACE A• KEANEed in Westchester County IC,STATE OFu"Ihle Expires October 25 2025 on NEW PORK No.02KE6g24070 uOlillod In Westchester County►es October 25 2025 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 .Building Permit Check List&Zoning Analysis Address.• �� 1—� ( -Q. SBL• Zone: �12 Use: Const ype Other. Submittal Date: t Revisions Submittal Dates: Applicant: \C Da s- Nature of Work: -Q �2C'. \ N\ Sr 1�p ls� R e<:-S \� Reviews:ZBA: BOT: Other. NEED OK ( �P� FEES:Filing: \ BP: C/Cr Flood Plane: Legalization: APP: Dated /fllotarized: J SBL: truss I.D. Cross Connection: H O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Stone Water Review: Street Opening. ( ) ( ) ENVIRO Long Short Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmt: Tree Plan: Other. ( ) ( ) SURVEY.Dated Current: Archival• Sealed Unacceptable: (�� ( PLANS:Date Stamped Sealed ✓Copies: 7i Electronic Other. (� (� License:,,'Workers Comp-&- Liability. Comp.Waiver. Other: ( ) ( ) CODE 753#: Dated N/A: (GY ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit: N/A: Other: (� ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit. N/A Other. ( � ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery:_Other. PLUMBING Plans: Permit Nat Gas: LP Gas: N/A/: Other. ((Y ( ) FIRE SUPPRESSION:Plans: Permit N/A Other. L l�[��, & H.V.A.C.: Plans. Permit: N/A: Other. y ( ) ( ) FUEL TANK:Plans: Permit Fuel Type: Other. ( ) ( ) 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER C/O DENIAL LETTER Other. ( ) ( ) Other. ( )ARB mtg.date: approval• notes: ( )ZBA mtg.date: approval:- notes: ( )PB mtg.date approval;- notes: REQUIRED EXISTING PROPOSED NOTES Area: REQUIRED Circle: Fronta¢e: Date: Front: Front: Sides: Rear. Main Cov: Accs.Cor. Ft H Sb: Sd.H Sb: GFA: Tot.imp: Ft.imp: pg!jw. Height/Stories: ` \ notes: Y (,A(xCA S lJa2_c 4" t-P4;-2IZ CQ._ lV�I S ZoZd Qs �.��, CCU �c 2(]rxtr� �b►r }32 ox ,O(�l ofV%0 W g�� t� 1t14.; 14 e AI- aN 48 ,. r , i Y. r Yj' M rr . y a , :'�S'?►� t 5 �,to r. ': ►; , + , ► *,: . 1 i ' i r i 4. I / ' J i f� Y - f r� 11/6/?4, 11:58 AM 1998.jpeg OC 01 00 lasso r.CX 2124811325 NY NATtuNAL 2 4j uuz.uu: IKiV-31-20BB Il 1S LSEZtryrl t ASSOC. 91A M 130.3 a.02/03 �- Lot 'fop ' A► �1 iry ` J Lot Lrr ��� 4%� MQ 1 a Ab Air �'�' 4w.. �s '' ► 1A J, Lr��s � l tarty i fow~/ 0 1 J LeL ALIw 461f9 sp/l. lot I&P i I Survey of Property P. o•a prepered for Bellf__j'slj• iiommas 8a Land CofnpA t� in the vii ,oge of o rtye Broolc Town of Rye West<, 1)ester County, N.Y. ID Scale 1"=20' Sept . 21, 1998 Any AW AK 1"0 ,..,.......,�. :......Iw A Jraa NOV - 6 2024 77tr/r.�.p ICY LN 7!J w Mr..✓••.ti► Slio.lii.Ate.r/MAV LMP w awfAl.k.N~Ft AV a AW�W`CMYNY L r r j Lax MN V.*,W � � * ���Cm p p WAS I~ VILLAGE OF RYE BROOK BUILDING DEPARTMENT ?IwdArvM I1WW�w m.Mni.,!.r R—W Aw I••IIA, of i.A. 41m m-dlsw 2 .I Mr Al►rlr.AN.JAaa10 Lr.. b✓j.'A►**N sw myw.a n'^•1 w.V+.s wM!M u✓�i r..M m....I.rJ1.r �'%�."lal,^ rrN.1.I!r..w.t:.WM r Awr m.I wW Cr., T.►A.V"f J.00~A~Aror LML Lf)""v .w A'7�w w.w�w.r•.iM nr �1�-/:!•,�r • f eaF✓pwr.r.Ar J~dr.r)*whrhY 4 r+.ww.!r+Sblr Mwbn*W LIv AwOrx Aw crrp lN,e^r wr+k.ro av raw.AY M.r.!w.ff."W s fib. --Ir; 1.•k a AI MMr N Mr lMr CMr'� /••r^•"•••'tw' W I.rl.y lr 1W N /M IIr.Y�pea M/A.Ir AW _ M- 7AIO A-A-.AAlINU Ay eOmbIM1.I.iA7,/Lp►'f LM Cyr.gV/r/ NA/-wm w.W C v. 1.:wwx ..c .v rah AbrwA . -A - M 40 No.a691 a 0, A24 A .er)4 a, bttps: /mail.google.com/maillu/0/#advanced-search/from=ggoldberg711%40gmail.com&to=archbgo%40optonline.net&subwt.:el1&attachatrue&withinmld&sizeoper... 1/1 ACO'R�R CERTIFICATE OF LIABILITY INSURANCE 7DATE(MMIDD/YYYYI 3i 18/2025 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 holier 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 MICHAEL J DONNELLY NAME: Donnelly Insurance Center Agency Inc PHONE (914)347-6500 FAX (914)347-6303 C.N Ext: A/C No 6 North Lawn Ave. E-MAIL ADDRESS: INFO@DONNELLYAGENCY.COM ADDRESS. P.O.Box 880 INSURER(S)AFFORDING COVERAGE NAIC 0 Elmsford NY 10523-0880 INSURER A: MIDVALE INDEMNITY CO 27138 INSURED INSURER B: NGM Insurance 14788 Royal Comfort LLC INSURER C: HARTFORD ACCIDENT 8 INDEMNITY 22357 PO Box 718 INSURER D: INSURER E Jefferson Valley NY 10535 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2522735661 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 ADDIL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IYYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAMS-MADE ®OCCUR PREMISES Ea occurrence 75- S 100,000 MED EXP(Any one person) $ 5,000 A Y GLP1087788 03122.r2025 03/22/2026 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 PPOLICY ®JECT LOC PRODUCTS-COMP.'OP AGG $ 2.000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea aocident ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BIU3828T 06/08/2024 06/08/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per aaxlenl S UMBRELLA LIAB i OCCUR EACH OCCURRENCE $ EXCESS LIAB 11CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'L1AB`rTY STATUTE Y/N ER NEE ANY PROPRIETORIPARTA'EXECUT1VE E.L.EACH ACCIDENT $ 500,000 C OFFICER MEMBER EXCLUDED? N/A 16WECAF5CPS 04/06/2024 04/06/2025 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) HVAC CONTRACTOR CERTIFICATE IS SUBJECT TO TERMS,CONDITIONS AND EXCLUSIONS OF THE ACTUAL POLICY AT THE TIME OF ISSUANCE.CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED AS PER WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 KING ST AUTHORIZED REPRESENTATIVE RYE BROOK NY 10573 G 1988-2015 ACORD CORPORATION. All rights reserved. Workers' YYORIc CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a. Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured ROYAL COMFORT LLC 914-299-8600 PO BOX 718 JEFFERSON VALLEY NY 10535 1c.NYS Unemployment Insurance Employer Registration Number of JE 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 815236971 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) THE HARTFORD VILLAGE OF RYE BROOK 3b.Policy Number of Entity Listed in Box'1a- 938 KING ST RYE BROOK NY 10573 16WECAF5CPS 3c.Policy effective period 04/06/2025 to 04/06/2026 3d.The Proprietor,Partners or Executive Officers are included.(Only check box if all partners/officers included) XJ 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 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: Michael J.Donnelly (Print name of authorized representative or licensed agent of insurance�arrier) Approved by. 0 29 O /8 ZD (Signatu (Datol Title: AGENT Telephone Number of authorized representative or licensed agent of insurance carrier: (914)-347-6500 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) wvvw.wcb.ny.gov "' `T4G /may ` y SELL_- y+hXYwVd' � � ni 1 :1r ,! {Y rA SAP^ ,�;FSvtJ +��� y,ry r 4f# ar £t>hT�.; F ffE� 1r, F; 17j1 t1L.VE� t F 1V v h '•� M § f^> %� ; F;,ti i,n„_ ytl�+ e; � - a Fopp; } ' � `9 t `y rr tit ifs.�._ tb '=t N/ r yt �J �t t russxrnsJ'Zt \ c o v C o OLn z? N J cr cu CQ al �F �„ i cpi � � p �1 . �• J LU oej Oj f' J ram- W Q v JUJ GCL s� rL ui 1. �� �_ c �,. � IW W � 4 1 h�w 11•�1 �+ #� 1 � � cq 72 f9 i Jel y a I / '""" -��..�.'� '`4"�s8•-�, '`.:�F j .a`C. s d�4�� Ct�'x�n::«.e�`r..4v:.,k "��rr'` U` •` x r� A CERTIFICATE OF LIABILITY INSURANCE T (MM/DD/YYYY) 0 / /2025 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: BIBERK PHONE FAx P.O. BOX 113247 E MAILo.Exn: 844-472-0967 (AIC,No) 203-654-3613 Stamford, CT 06911 ADDRESS: customerservice@biBERK.com INSURERS AFFORDING COVERAGE NAICS INSURER A: Berkshire Hathaway Direct Insurance Company 10391 INSURED INSURER B: A E P Fire Sprinkler Systems LLC INSURER C: 51 Pocantico Street :INSURER D 1 INSURER E: Sleepy Hollow, NY 10591 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YY MMID LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00( CLAIMS-MADE 1-i-I OCCUR DAM—AGE TORENTED PREMISES Ea occurrence $ 50,000 A N9BP758803 06/17/2024 06/17/2025 MED EXP(Any one person) $ 5 OOC PERSONAL BADVINJURY $ Includec GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,00C POLICY❑JJECOTT LOC PRODUCTS-COMP/OP AGG S 4,000,00( X OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per a L $ ccident UMBRELLA LUIB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS LIABILITY Y/N STATUTE ER _ ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? ❑ NIA - - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under -- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability (Errors & Per Occurrence/ Omissions): Claims-Made Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) This policy is primary as to losses it covers, and the Insurer will not seek contribution if there is a written agreement between the insured and the certificate holder. Village of Rye Brook Building Department is listed as additional insured as it pertains to general liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1051 Boston Post Road ACCORDANCE WITH THE POLICY PROVISIONS. Rye, NY 10580 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserve, ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 4 \\ NYSIF New York State Insurance Fund PO Box 66699,Albany. NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE � TWL A A A 612095215 A.E.P FIRE SPRINKLER SYSTEM LLC 51 POCANTICO ST SLEEPY HOLLOW NY 10591 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER A.E.P FIRE SPRINKLER SYSTEM LLC VILLAGE OF RYE BROOK 51 POCANTICO ST BUILDING DEPARTMENT SLEEPY HOLLOW NY 10591 1051 BOSTON POST ROAD RYE NY 10580 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2592 552-0 802369 06/17/2024 TO 06/17/2025 2/21/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2592 552-0. 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, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK. TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. 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. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR. PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. 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 FUNS T �V DIRECTOR.INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 535717501 U-26.3 Ait George Latimer r James>laisano l \N'estthcster('nun"F.%eeutilc oL)lnt� Director,Conemncr Protection i CillSj ..". 4 Department of Consumer Protection `" llome Improvement License NG BUILDING SOLUTIONS INC. 36 NORTH ROAD WHITE PLAINS,NY-10603 T• ;? 1 his bcense is issued in accordance wi1h Article XVI of the Westchester l'ounty Consumer Prot"Ii(mi Code and is valid on IN upon presence of the official department scat.Pnxdofcitizenship or immigration status is not required for issuance of this license y NOT FOR FF.DFRAL PURPOSES x �GonsuT� License Number Date of Expiration " WC-37186-H23 Is ' 12/13/2025 - r ;atop r -:?'• �t+ E~ ._� i"t� .•. n-�-,1..4 J^111y It �!5 !e' i'sti fjjl "'y ?f�J" t e �. 'flJ�f11' 1�t � fIIJ.111 JJ ti �fl 11?t ii u 1 i15rs 7' 1JitA; ,.i�a- ���'•¢��,�� ��..�"9�,tw'.., y` �1JA�t.<. `, -`Jip�•� �. ��t;< � �+"`lY?��y'� � �:Y,+' � � ; .11 Phone: (914)939-0668 ACORO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 09/26/2024 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 Capital & Co Insurance Services NAME: Joana Parungao 5455 Wilshire Blvd, Suite 1816 (aG No Ext): (310)492-2007 fac.No): (310)525d292 Los Angeles, CA 90036 ADDRESS: cs@capcoinsurance.com License #: 6002332 INSURER(S)AFFORDING COVERAGE NAIC• INSURER A: Obsidian Specialty Insurance Company 16871 INSURED INSURER B NG Building Solutions Inc INSURERC: _ 36 North Road INSURER D: _ White Plains, NY 10603 INSURERE. INSURER F COVERAGES CERTIFICATE NUMBER: 00009935-80975 REVISION NUMBER: 27 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYpE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY SCB-GL-000057099 07/07/2024 07/07/2026 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR REMI ES(Ea RENTED ncel $ 50000 MED EXP(Any oneperson) $ 5 OOO PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 OOO OOO X �POLICY❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIM $ Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Par P acc en1 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I PER Y I N OTH- AND EMPLOYERS'LIABILITY ATUT ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA EL.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOY $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 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 BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN VILLAGE OF RYE BROOK ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street, Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE JJP ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are reowtered marks of ACORD Printed by JJP on 09/26/2024 at 11 46AM fi \\ NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE [i]P.. , � AAAAAA 932003858 rq '� CARMEN TACLE INSURANCE BROKERAGE � • 5447 65TH PL ry MASPETH NY 11378 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER N G BUILDING SOLUTIONS INC BUILDING DEPARTMENT 36 NORTH ROAD V ILLAGE OF RYE BROOK WHITE PLAINS NY 10603 938 KING STREET RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2593131-2 257813 06/29/2024 TO 06/29/2025 9/26/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2593131-2, 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, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. 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. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. PRESIDENT LINA M GIRALDO SOLE OWNER/OFFICER OF NG BUILDING SOLUTIONS INC 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 STAT SU NCE FUND /!�Y 4/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 770403022 U-26.3 E I TING MNDOVV TO B REMOVED ED, PROPOSED E REW WINDOW TO BE - ,` INSTALLED IN LO ATM OF STING WNDOW WTH �' I i I I RF 1 �, w 1A I LIGHTNG C II PLV% T SILL HF HT I EXISTINGWL ," LESS� "� i CLI _ I Ii I gra I WI NJ I''=II 1 FLf_FLl`�-I S I I ..I SECTION F CISTII� '��II'ALL T CBE FED ar��� I�'+1' REMOVED IMPACTED — J I � � I 1 � ,� � �� � ' , BY PROPOSED VANDOW CD z r t .�, I — r° ST 1 D�T BE REMOVED EMT "�INSTA ULAD I TO � -- _.. I I I PAIRED # REPLACED I E I' PEED EMERGENCY BA+ UP LII 1 I I p E( IRED. FINtSHEB — I CL I ICI J ' 5 � I wl DOSTM T�EISTIf"�i ,r- CL L I EXISTING f ' -.. � FR�I LIGHM + EGRESS WINDOW f� I 1 � R LEVATION z t? SCALE: ■ integral OUSnNG ffigf� r Lr ' ' L�CER IN ly �ao MAC EQUIPMENT r-_.�-_����_a_s_---- --_-_�_�_��- -�, �`�__----- 7Mai :a EXI _u 1 100w�=, ° r'�`''cFF Ferry,I '10522 VVELL "_ uft i OWEAD _icSnNG -274-8874 :a 914 .. . IFS'STATUS OF�TIIV EQUIP.v TILAT O . � L� S � �- 7 -03 � DE FRESH AIR AN IN A CAN OR APPROVED � .) z lir O. , OV I E� CASEMENT MIN E info@inW en rg.com :e 2 - MA A REQUIRED BY NYS BU LDNG CODE - �H .� i' �l4�hIII`8I1grg.+C4 W I STING MIN. RE RATED�P �I ON I TI SELF LEI HIE CELM L AM ANCHDR FRMI W., �AGOF YE FIST. �-- I STALLED rq IN NCLOSET 10 &D - uu �. WINDOW WELL h A'1 cq Ti t& I HARDOMM EXISTING G 0 0 EXISTING'"V NDOW WELL T �N EXCEEDS RECESSED, �"� � � � � THE 36'x 36'MINIMUM U SPECIFIED CODE. I � I � � I LIGHTING PLA +C MEDIA► ROOM E PI f CE E STING W ND�CI WELL T BE � � � � I I r � _ �.�..+1 �C 8 56. * REP RED AND SECURED AS REQUIRED. I I � � I I PR F' SEO EMERGENCY CEILING Frcr �. C uyp - BACKUP LIGHT +�' � < � ES E LADDER OR STEPS TO 13E INSTALLED I LIGHTING �G �.„ EXISTI G cT I T, UJ Z 0 0 — STII' ND WELL T THE SATISFACTION �� EXIST. _ LLJ 0 z E THE RYE BROOK BUILDING DEPARTMENT. BATHROOM HEAD CLOSET �- UJ A PLASTIC COVER AS APPI ED BY THE RYA --�--� ------ --- � � I I � 0 BROOKBUILDII' C DEPARTMENT TO BE INSTALLED I L� EIUNG *- rl*ft > a: OVER THE EXISTING WIND WELL -� � I'�r:��-�� LIGHT � 'I 'W � ------ � � PLAN PREPARED�� � T a ENT" sTSPRMWU.ERBRADLEYSMMI.M OLSEN SPRWKLM EGRESS WND W TES -� ,� MEMO 1 QD POUND RfDGE,NY 10576 E STING WINDOW IN E cISTIIG WINDOW WELL TO EXIST.DOOR ADD SECTION Phone: (914) 764-9578 BE.FEMVED.#VEV11 WINDOW TO BE INSTALLED T EXISTING EXISTING Of WAU TO BE READ EXISTING L*HMM ART AREA _ - I Mobile: (914) 60-1 HOME OFFICE I � . MEET R EXCEED THE I!r�lINII�k.� 'I EGRESS UNFINISHED ram. � - � I � �� . REQUIREMENTS ENTS AS PER IYS BUILDING CODE, VF1 _3 � I��ED � mail. bigAREA , UGH7ING 46 OL IF uj �.) I ISSUED DAT A Z MIN. "CLEAR OPENING WIDTH �, � CLEAR -� � BUILDING PETIT 10-24-24 20 MIN. �CLEAR OPENING HEIGHT REVISED PERMIT 11-19-24 MI1 .5.7 S 5T.CLEAR OPENING � RASED ER ff 1-20- 4NOTE CLEAR OPENING MAX.440 ABOVE FIN,FLOOR ALL WORK SHALL BE PERFORMED IN STRICT � STI FINISHES T 71 E PATCHED l � COMPLIANCE I TIC�UNIFORM FIRE PREVENn N EXIST. EXIST. EXISTING CLOSET CLOSET 'WATER METE REPAIRED AS IE �+UIRED AFTER INSTALLATION F AND BUILDING LE �F NEW YD�STATE AND ALL -- - - AUTHORITIES HAVING J RID IDTI N. CLOSET ' PROPOSED WINDOW. ALL PROPOSED FINISHES - . TO MATCH EKING. BASEMEN_ ` FLOOR � OF DATE: 2 NOVEMBER 2024 ki