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HomeMy WebLinkAboutPP25-035 C 4R, J p VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury www.gyebrookny.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 15,2025 Scott Hirsch&Christine Staeger-Hirsch 1 Beacon Lane Rye Brook,New York 10573 Re: 1 Beacon Lane, Rye Brook,New York 10573 Parcel ID#: 135.58-1-11 This document certifies that the work done under Plumbing Permit #25-035 issued on 3/6/2025 for the installation of a new gas boiler and hot water heater has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �yE BRCZ: • cu � 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.Eyebrook.org, - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : DATE: //" // 0 ,1�f PERMIT# ISSUED: SECT: '._��BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER s a s a : LO N m N M r \ �p OQ W en ■ V) 0" m •—� u VV _ W N m s W Q u a cn Aw � W z Q w to 00 x x F ON = w j--q \ o o V) � m Lr, o , A a H x I . 1-7 z a WM z zit00 A Fc W : w v� oZ z U w a V w0 w pa p C7 O F p CJ) z � o 0.0 m en z W Cl) A O e may . e, BUILA �DEPARTMENT MAR - 6 2025 3D VIL ' E OF RYE BROOK 938 KINGS ET RYE Blt NY 10573 VILLAGE OE RYE BROOK E ) . , BUILDING DEPARTMENT www Fit*tjokny.gov PLUMBING PERMIT APPLICATION FOR OFFICE USE ONI.I' BP PP#: J ' Approval Date: MAR U 6 20 5 Permit Fee: S Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED UN'THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE.TOTAI.COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 3—&-c)Q is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove 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: � 3f'A '_o N LAti 4 SBL;�3�, J —f—l' ,Zone: —10 2.Proposed Work: Do.Lt" � r+1J o SN�G v,� Swta P 3.Property Owner: /41 2 S e H Address: / 61.6 L / Phone#: q/-4 QdZ � ?�`� `C Cell#: email: Se 14.13c! 4.Master Plumber: f�S o Cst I�Is ,�.v Address: Z4 6 /V 4"e /P.) Lic.#: / Phone#: �y q3�P-A) Cell#: email: Company Name: Ate►i e 1"A cAA— I e--P Address: y 6 o ry WA 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 1 st Floor 2nd Floor 31 Floor 4'h Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: 8a((.- (Notarized Signatures Required Next 2 Pages) -1- 6/1/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duty 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 t Sworn to before me this day of 20 da of ,20 11AIAr1 GdN Signature of Property Owner Signature of Applicant S(.-\C 16 f St� it P ' t Name of Property Owner t DSL Notary Pub ) L EN Notary PUMIC,State of New York �OtaryPublic,State of New York No.01ME6160063 No.01 WH6394580 Qualified In Westchester County —1 Oualified in Westchester Cou^ty Commission Expires January 29,2f) ! Commission ExpirU duly 8,2u27 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 ti BUILD MENT 2 G Vu. OF RY OOK MAR - 6 2025 938 KING ET RYE BR NY 1OS73 ` U ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE �216 - STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST SEAR 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� 3, J Ok V ��- ,residing at, ,, T LV r— 1'I L! , C (Print name) (Address where you live being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; ` /ea C o/ Qf7 ,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 Property Owner(s)) (Print Name of Property Owner(s)) J Swom to before me this b day of a('C' , 20 ( -o ry Public) SHARI MEULLO Notary Public,State of New York No,01ME6160G63 Qualified In westchester county Commission Expires 3andary 29,20L� 6/1/2Q24 �s { O N N W _• LO N o N a N N � O M W N M a v M > � w 46 14 s Ln C r+r _ h�l Leien z f 4 CCi N00 o Ln Go W U , V 7 s en w z z f l ,t V A = ; ocen � W O .� W x w w N H o z u c x S Q Ls: N F o Z � 4 a � x = t •L• �'� Q J r w �, J a. 4t F�_ �n BUILDING DEPARTMENT D E C E Q V E VILLAGE OF RYE BROOK 938 KING iAFET RYE BROOK,NY 10573 MAR - 6 2025 (314)"9=0668 www.ryebrookny.gQvv VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATIO Westchester County Master Electricians License Required FOR OFFICE USE ONLY r$P 03S EP#: 1�), 06 e= Approval Date: XNPermit Fee: $ \__ /10 Approval Signature: Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove electrical equipment, wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. /� 1.Address: SBLn y : IS5 iS�l"'�� Zone:,C /0 2.Property Owner: A' ' c�1�L� Address: ( yeggm (A.44- Phone#: "1 11'- q O Z" U�!- Cell#: email: G 3.Master Electrician/Licensed Installer: e_ (gtrtn.c'+ Address:�a s Q'/x 42* �' 74- Lic.#:C�16 Phone#:q�y'�13y'l�� Cell#: 3s6-3ZZYmail:U bf-G--�4 fo 4.0 ( • cta�• Company Name:V,EL 1 c-A UZI(?M•gw"#- Addressq'V_ '0001k V-1e,7•G(- 4- 4 � �o rKkls•, 4.Proposed Electrical Work/Fixture Count: War`'n�-t •� i�„S 1�.�(.�;a ©� Nc� Q����" 5.3rd Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual nin as the app anntL state that(s)he is the � k -r-" 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 b fore me his Sworn to before me this l9 day ef cc ,20 day of f(/��� ,20 -1,S f,Q,u,&1Mod JANDRA LARIZZA Signature of Property Owner NOTARYtmton STATE A6 NEW YORK tnttion No.G I LA63`s3116 J ` ` in Westchester County `��ission Expires 03t27I2021 n ame of Property wne Print me o Ap !cant Ngqffr�#Wfitate of New York No y Publi .O1ME6160063 6/1/2024 Qualified In Westchester County Commission Expires January 29,20Z-_7 STATE WIDE INSPECTION SERVICES, INC. 0•0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# J _ Date ./ 10/ Bldg Permit# Sq Ft Plumbing Permit# ,� 1 Final Certificate# City/Village Zip � Building Dept. �/oa4, County ,� lSi t j Address Cross Street Section Block Lot Owner Name/Address Of different than above) Contact Number ❑Basement ❑ 1st A. ❑ 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 zPanels 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 ) 1f 'A� �'�i I •� ��4��5{„fit � /�4.� ��r {f'v Em,, 6 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 ':)I+ k-c-l' - Zip Code Company Phone# ���� S_ State Wide Inspection Services CA� APR - 9 2025 1080 Main Street Fishkill, NY 12524 44AWK/ Uri 845 2 Phone ' 914-219-119-1062 Fax STATE WIDE INSPECTION SERVICES Email: office@swisny.com Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Gene Branca Electrical Contractor Scoot Hirsch&Christine Staeger Hirsch Gene Branca 1 Beacon Lane 78 South Regent Street Rye Brook, NY 10573 Port Chester, NY 10573 Located at: 1 Beacon Lane, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 25-062 135.58 11 Certificate Number: 2025-2090 Building Permit Number: 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: 1 Beacon Lane, Rye Brook, NY 10573 The Garage 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 Day 8th of April 2025. Name Quantity Rating Circuit Type Boiler 01 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. HTP Advanced Heating & Hot Water Systems www.htproducts.com SUPERst The Best Selling Indirects In North America ! 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-Stainless Steel Aquastat well Stainless Steel Cold ,w. l Water Inlet _ � �p 1"Boiler Return Connection Dimensions & ` Specifications C A ^ A C G ski s2 s2 � --® R2 D --—_ E ..i' R1 R2 F - __wJ S1 B R 1 A B C D E F G Heat Shipping Model Floor to Capacity Exchanger Dimensions Diameter Domestic Boiler Floor to Boiler Supply Floor to Boiler Domestic Surface Weight Ht Connections Connections Return Out SSU-20N 27" 19 1/4" 3/4" 1"NPT 51-9 3/4" R1-5 1/4" 22" 20 15 SQ FT 51 LBS SSU-30N 39 1/2" 19 1/4" 3/4" 1"NPT S1-9 3/4" R1-5 1/4" 34" 30 15 SQ FT 62 LBS SSU-30LBN 281/2" 23 1/4* 3/4" 1"NPT 51-9 3/4" Rl-51/4" 22" 30 15 SQ FT 71 LBS SSU-45N 52 1/2" 19 1/4" 3/4" 1"NPT 51-9 3/4" Rl-5 1/4" 46" 45 20 SQ FT 72 LES SSU-60N 52 1/2" 23 1/4" 1" 1"NPT Sl-9 3/4" Rl-5 1/4" 46" 60 20 SQ FT 109 LBS SSU-80N 72" 23 1/4" 1 1/2" 1"NPT S1-29" R1-6" 64 3/4" 80 34 SQ FT 143 LBS SSU-119N 74' 27' 11/2" 1"NPT 51-30 1/4' Rl-7 1/4" 66" 119 34 SQ FT 212 LBS SSU-45CN 42 23 1/4" 3/4" 1"NPT S1-9 3/4"1 S2-18 3/4" 111-5 1/4" R2-14" 35" 45 40 SQ FT 106 LBS SSU-60CN 52 1/2" 23 1/4" 1" 1"NPT 51-9 3/4" 52-18 3/4" R1-51/4" R2-14" 46" 60 40 SQ FT 126 LBS SSU-80CN 1 72" 23 1/4" 1 112" 1"NPI 51-29" S2-29" R1-6" 22-6" 64 3/4" 80 68 SQ FT 175 LBS SSU-119CN 1 74" 27" 1 1/2" 1"NPT S1-301/4" S2-301/4" R1-71/4" 112-71/4' 66" 119 68 SQ FT 242 LBS www.htproducts.com 272 Duchaine Blvd, New Bedford, MA 02745 0 HTP • LP-81 • 0112020 / Condensing Gas Boiler Ratings - 6 sizes Series 3 CT 80 MBH Loa Ab j 105 MBH 155 MBH 230 MBH 299 MBH 399 MBH k � F i' 4;+ r xf`. d " fx' _ �Yd (C Y� 1� 4 k 1 •'C iPr'. _ As fuel costs soar,home heating efficiency is on the mind of virtually every homeowner All Ultra boilers feature a high AFUE efficiency level.This is one of ` 4j the highest efficiency levels in the industry,and when the Ultra is used in low-temperature applications such as radiant heating,it can achieve even higher efficiencies. :r , ' �"" The Ultra boiler is designed to be environmentally friendly and • exceeds the highest North American environmental air-quality standards In fact,it provides cleaner combustion for low NOx applications allowing for a reduction in green house gases. While fuel efficiency and the environment are highly important factors,here`s another-the Ultra system comes from Weil-McLain,America's acknowledged leader in boiler quality and reliability. For well over a century Weil-McLain has been single-minded in its pursuit of continual breakthrough innovation,backed by a solid commitment to provide the best customer service and support. f The new Weil-McLain Ultra,coupled with the industry's greatest , reputation for quality provides today's most comforting combination.By far. Ultra Gas Series 3 components O A negative regulated gas valve that precisely delivers gas to the boiler for Designed to optimize operation resulting in significant fuel savings. optimal performance © A variable speed motor that constantly matches combustion output to your heating needs. © A ventun mixing body that precisely mixes air and gas providing higher efficiency OO O A cast aluminum mono block heats faster- © aluminum provides 10 times better heat transfer than stainless steel. I © Water and gas piping placement are designed for quick and easy connection at the top or bottom of the boiler O Conveniently located for simple installation and servicing.the electrical components have been pre-wired and are connected to the U-Control Module with color coded 111 _ terminal block plugs OSimplified venting with PVC or CPVC for both exhaust and combustion au Slide the pipe into the top outlet Ilue pipe adaptors i f and tighten the restraining ring,without messy sealants. Achieve vent runs up to s Q 100 feet tiro O Side mounted service receptacle on a j O separate circuit for use with a condensate Iry pump,service equipment or service light. O Side jacket handles for easy handling. High grade stainless steel burner with - woven steel fiber mesh that uses pre-mixed air and gas providing for a 20% to 100%modulating firing rate. The burner is designed for long life and whisper quiet operation. Four adjustable boiler feet for easy placement and leveling ® The Ultra is lightweight compared to conventional boiler,requires minimal clearance and floor space.and can be used in floor standing or wall hung applications. M For gas-fired applications,Ultra boilers employ an advanced mono-block aluminum heat exchanger that transfers heat faster than conventional materials. Ultra's unique electronic sensor and control system allows key functions{ike the modulation of firing rates up or down,as conditions both inside and outside the home fluctut3t8. Unlike most other systems that merely turn off or on at a single preset indoor temperature, Ultra senses precisely how much heat needs to be produced at any given instant and adjusts itself accordingly. Feat Ing TM flexibility ?he result?Far greater fuel efficiency and far less wear and tear on critical internal parts. User friendly display screens. (Am-sum riMIL-rMUM Nino =01"6 The back-lit LCD display and simple programming buttons make entering and receiving information easy. It allows homeowners the ability to view current boiler status,check water and outdoor temperatures,review boiler maintenance schedule and view installing contractor contact information. t tf .� When matched with aWeil-McLain indirect-fired water heater, you will experience virtually limitless hot water -� ,. for bathing, laundry, d�shwash�ng and cooking at a lower operating cost compared to most other alternatives. Our indirect-fired water heaters provide A4UAPIus twice the peak flow of a tankless coil, 50°� more than Modes AvallaCbe 3S�5.55,E5.105 a comparable sized direct-fired gas water heater, and three times as much as an electric unit. Heating perfection 1 long—term protection. • Every Ultra boiler is hydrostatically tested to ASME standards and test fired • Backed by Weil-McLain quality and a warranty that provides peace of mind • Unrivaled support leading• From North Amedc& boiler over 1 year proud history WEIL•frkLA1N NMN 1M1)Ilt:]y1CCM11 The Exclusive U-Control Module Makes Boiler Set Up and Operation Easy *SET UP OPTIONS *TEMPERATURE MANAGEMENT i" Simple or as elaborate as you want -From 1 to 3 different setpomts for single or multiple zone type management FW i•s -ZONE TYPES *MULTIPLE BOILERS Choose predetermined settings or customize -Capable of controlling additional balers or heating appliances raaiw *`SYSTEM SENSING *SERVICE ALERTS Sense baler,system and outdoor temperatures -Use the standard screen message or customize with contractor information Standard Equipment Boiler Boiler Circulators U"erd Module •Cast Aluminum Block 1-Flanges 180 8 105i Taco 007 •30 PSI ASME Relief Valve t"8 ►-1/4"Flanges t 155&230)laco 0014 •3 5'LCD Display •Drain Valve 1-1/4"a 1-1/2"Flanges 1299)Taco 0014 •Three boiler priorities with multiple •Stainless Steel Burner(go 1051 1-1/4"d 1-1/2"Flanges(3991 Taco 0013 preset system configurations with woven steel fiber mesh(155.230.299 8 3991 •Coior-coded removable terminal blocks •Direct Spark Ignition Complete Jacket Assembly with •Multiple boiler functionality •Variable Speed Blower Assembly •Fully Removable Jacket Front •Alarm control functionality • .Ignition Control Venturi mixing system with Air Silencer •Adjustable Boiler begs •Negative Pressure Regulated Gas Valve •High Limit 8 Modulating Temp Control •50 VA Transformer •Sldewall Vent/Air Termination Kit •Low Water Protection •Dual Scale Temp 8 Pressure Gauge •On/Ott Power Switch •Outdoor Reset •Outlet Water Temp Sensor •Line Voltage Service Receptacle •Ability to control any combination of •Intel Water Temp Sensor •Condensate Trap with Drain Tee Assembly 3 Circulators •Flue Gas Temp.Sensor •Propane Conversion Orifice •Outdoor Temp Sensor (All except Model 80) •System Water Temp Sensors a�rzganel 22a - 174 4LsaoNrrcrtarf t� 37 T6 i 43& 61 r 6 ELICTRIC�lfrtRlllCEt Irrratf4 WRIN PETUPW \ WaTE11 SUPPLY Cokv*CTV)r+ COMIECTI[1N AM WLIT f LUT WAO Condensing Gas Boiler series Models Ultra 80 CT Ultra 105 CT Ultra 155 CT Ultra 230 CT Ultra 299 CT Ultra 399 CT Packaged Boiler Part No. Part No. Part No. I Part No. Part No. Part No Natural Gas --�T383.500.720 ' 383- 00 722 83 3 500-723 ' 383-500.72 ^383-500- 27 5 383 500 726 Propane Gas ` 383-500-721 383-500-722' 383-500-723- 383-500.724- 383.500-725- 383-500-726' Taco Pump 007 007 1 0014 0014 0014 0013 'Natural Gas field convertible to LP as standard equipment except for the Ultra 80 Optional Equipment Wall Mounting Kit 389-900-180 389-900-180 389-900-180 ' 389-900.180 389-900-t80 389-900-180 LM(w/twnessatesnww) ` 511-100-005 511-100.005 511-100-005 511-100-005 511-100-005 511-100-005 Concentric Vent Kit(3') 383.500-350T383-500-350 383.500-350 383-500-350 383-500-350 Indirect-Fired Matching Aqua Plus 35.45,55,85 and 105 Water Heaters are available Water Heaters Ratings .- - - CSA Input(Maximum) 80 M8H 105 MBH 155 MSH 230 MSH 299 MBH 399 MSH CSA Input(Minimum) " 16 MBH 21 MBH-,-----' 31 MSH �1 46 MBH _.-1 62 MBH____`-80 MBH__ DOE Heating Cap. 71 MBH 94 MBH 139 MBH 207 MBH 270 MBH '365 MBH Net 1=8=R ' 62 MBH i 81 MBH �123 M- 6H 183 MBH�T 234 MBH T 317 MBH DOE AFUE 93.g% _ 94.04!1 94.0% "1% 92.5% --*91.7% — 'Combustion Efficiency Data _ Vent Size 21, 3 2 or 3" 3" 3"or 4" 1 4" 1 4" Vent Material PVC/CPVC PVC/CPVC PVC/CPVC PVC/CPVC PVC/CPVC PVC/CPVC Combustion Air Size 2 or 3 2 or 3 3' 3"or 4 4" _ T4" n " n n 1.. i n Water Volume 96C,a1.�782 Gal. 1.17 Gal. - 1.57 Gal. 2.1 Gal. Approx.Ship.Weight 199 lbs. 207 lbs. T 234 lbs. 246 lbs. T 297 lbs. 297lbs. Dimensions Min.Recommended 1" 1"- --_ 1-1/4" 1.1/4' - 1-1/2- 1-1/2" Pipe Size Supply Tappings 1" 1" 1" 1" -� Return Ta ins - 1" 1" ` 1" 1" 1-1 j4" __�___ Gas Connection Size T 1/2" 1/2" r—� 1/2" — _1/2" 3/4" 3/4" ® DATE(MM/DD/YYYY) ACC)RO CERTIFICATE OF LIABILITY INSURANCE 12/14/2024 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 NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY PHONE- HOME OFFICE: P.O.BOX 328 (A/C,No,Ext):888-333-4949 (A/C,No):507-446-4664 OWATONNA, MN 55060 ADDREss:CLIENTCONTACTCENTER FEDINS.COM INSURERS AFFORDING COVERAGE NAIL# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B:FEDERATED RESERVE INSURANCE COMPANY 16024 ARCTIC MECHANICAL INCORPORATED INSURER C: 460 N MAIN ST PORT CHESTER,NY 10573-3310 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:90 REVISION NUMBER:0 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDDIYYYY MM/DD/VYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR EAMAGwE TOceRENTED PREMISES $100,000 MED EXP(Any one person) EXCLUDED q I N N 1887386 01/18/2025 01/18/2026 PERSONAL s ADV INJURY $1,000,000 OEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 X POLICY FIECT LOC PRODUCTS&COMP/OP ACC $2,000,000 OTHER: A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $1,000,000 t/ X ANY AUTO BODILY INJURY(Per Person) A OWNED AUTOS ONLY SCHEDULED N N 1887386 01/18/2025 01/18/2026 BODILY INJURY(Per Accident) UTOHIRED AUTOS ONLY NON-OWNED PPReOPAEcRTYY DAMAGE AUTOS ONLY X UMBRELLA LIAR JOCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS-MADE N N 9907994 01/18/2025 01/18/2026 AGGREGATE $5,000,000 DED I X IRETENTION$10.000 WORKERS COMPENSATION X I PER STATUTE I OTHER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $1,000,000 B OFFICER/MEMBER EXCLUDED? N/A N 9298530 01/18/2025 01/18/2026 (Mandatory in NH) E.L DISEASE EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE POLICY LIMIT $1,000,000 i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached i1 more space is required) CERTIFICATE HOLDER CANCELLATION VILLAGE OF RYE BROOK 90 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 938 KING ST RYE BROOK, NY 10573-1226 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD YYO K Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a, Legal Name&Address of Insured(use street address only) 1b. Business Telephone Number of Insured (914)934-8301 Arctic Mechanical Incorporated 286-468-4 460 N Main St Port Chester, NY 10573-3310 1c, NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State, i.e., a Wrap-Up Policy) Number 06-1596446 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Federated Reserve Insurance Company Village Of Rye Brook 3b.Policy Number of Entity Listed in Box"1a" 938 King St 9298530 Rye Brook,NY 10573-1226 3c. Policy effective period 01/18/2025 to 01/18/2026 3d.The Proprietor,Partners or Executive Officers are �X included.(Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1a"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: Melissa Kopperud (Print name of authorized representative or licensed agent of insurance carrier) Approved by: _)_ Q / ��pj,� 12/14/2024 (Signatug) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 888-333-4949 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov