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HomeMy WebLinkAboutPP24-118 yE DR V t 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 May 30,2025 Richard Mast&Fran Mast 6 Talcott Road Rye Brook,New York 10573 Re: 6 Talcott Road, Rye Brook,New York 10573 Parcel I D#: 135.49-1-12 This document certifies that the work done under Plumbing Permit #24-118 issued on 7/31/2024 for the installation of a new oil fired water heater has been satisfactorily completed. Sincerely, z a4 Steven E. Fews Building&Fire Inspector /to �E 4ROO/ �m , 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 :— A L C c->-t_ DATE:_ PERMIT# 4ISSUED: SECT: BLOCK: LOT: LOCATION: h 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 i s e i a z v � W i Z H z w O s 010 oo w � � t z 00 in cn x A w w � z z �u H uz a a z z z w w � H E S a w o0 " W a a w C z z 6 cn � ~-1 �-1 W �°" v/i RC,-� BUIL ING DEPA MENT VIL E OF RYEn OK JUL 3 Q 2024 938 KIN Rl l T RYE Bl�0() ,NY 10573 _ VILLAGE OF RYE BROOK ww l4o .org BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: CD Approval Date: JUL 3 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: t SBL:L a - - Zone: 2.Proposed Work: 1�- 04A,) 1(� �QcY1L ��C? [YZ ► n 1 3.Property Owner: ki r'(�C1�C�' Address: 9N \►P L�C1�P . Phone#: -1AN-) • \5Lk , Cell#: email: 4.Master Plumber: o 1 Address:l�� � �b lit 9\C5 Lic. #: 1y _Phone#:CI -1-79 -Cell#: emaiL L ,J Company Name:j CCS'�t oL& ri tt)A �[ p Address: . 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 i I st Floor ` 2nd Floor 3rd Floor 4'h Floor 5`h Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 3/3/2023 STATE OF�, COUNTY OF ) 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 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 (—?�C' Sworn to before me this '��D day of 1�k 5,, ,201 day of ,20 Z\k Signature of Propert3COwner Signature of Applicant i va- Print Name of Property Owner P ' t Name of Applicant ��, ( Notary Fublic Notary }igyELILLO SEAM LYTLE Notary Public,state of New York No.OIME6160063 NorARYPUBLIC Qualified In Westchester County— My COrnmission Expires Aug.31,2025 Commission Expires January 29,2 T',..is.applicatie:ii nii�st be properly completed in its entirety and must include the notarized signature(s) of the to ,gal.owneY(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- 10/30/2023 BUILD NC DEPARTMENT DDD V'L E of RY>E: B OOK 938 KING ET RYE BROO> ,NY 10573 JUL 3 0 2 224 `;(014)939-0668 .r .ehro k.or VILLAGE OF RYE BROOK 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 I`��K, COUNTY OF R } as: 3J, IFt-o-n' , M ► [.rC~k,1 a- , residing at,1 w2 (Print name) (Address where y u live) being duly sworn, deposes and states that (s)he is the applicant above named, and further states that (s)he is t e legal owner of the property to which this Affidavit of Compliance pertains at; Lp -_T�Acr,>k &,,,r_R...k 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. 'e'x- ", /k (Signature of Property er(s)) ze,'c tirprz� r �A r 7- (Print Name of Property Owner(s)) Sworn to before me this �7 t e h day of r k , 20 d Y (Notary Public) f SEAN LYTLE N0rARYPVB11C -3- I11y CCMMISSIOn EXPires Aug, 3f,2025 8/12/2021 B4- K,. WATER HEATERS # 1 Selling Oil-Fired Water Heaters ■ Five-Year Limited Tank/Heat Exchanger Warranty - Residential Installations ■Three-Year Limited Tank/Heat Exchanger Warranty BOCK -Commercial Installations WATER HM7M • 104,000 to 623,000 BTU/hr • 32 to 113 gallon capacities • .64 UEF rating • 125 gallons first hour delivery • Glass-fused-to-steel water tank • Dual magnesium anode rods to inhibit corrosion Turboflue° High Performance Heat Exchanger: • Patented helical-fin multi-stage design • Superior heat conduction and fuel efficiency Made in the USA The Popular BOCK" 32E Leads The Industry in Energy Efficiency With a .64 UEF Rating and 125 Gallons First Hour Delivery OIL=FIRED -WATER HEATERS- -- ------ ----- - ----- - -- — ------- BUILT LIKE A BOCK This product is available from: B(- CK OIL-FIRED WATER HEATERS• Cludet D High Limit Outlet -tlet Inlet O O owea Wetlet Rel ef D Valve T&P 6 Outlet Inlet Relief T&P valve Aquastat �r s Connection valve T&M c"°o^an rn�^ O We lnlet/ Hann-Hole O Re[um A Hand-Hole CQ lrletlion CmineGCan� p a A Return A Inlet -Hole[ Dam Drain HandDrain vRe�tum Valve SOES vaNU Rn Retu n 0 E (a O e 0 E 0 E 1 32E,50ES*,51 EC 33E 72E,120E,361E 541E *50ES does not include outlet nipple and has high limit tapping(for 180*controls) Recovery Dimensions in Inches(cm) Rated @ A 90*F Inlet Outlet Return Shipping Weight Input (32*C) Max.Temp Pipe Pipe Pipe LBS(kg) Storage BTU/HR GAUHR Setting Dia. Dia. Dia. A B C D E Model GALL) (kW) (UHR) V(`q NPT NPT NPT I Standard ASME 32E 32 104,000 114 160 .75 .75 75 51.00 20.00 6.00 11.00 17.00 225 N/A (121.13) (30.48) (431.54) (71.11) 029.5) (50.8) (15.24) (27.9) (43.18) (102.06) 33E 33 104,000 ill 160 1.00 .75 75 43.25 24.00 6.00 N/A 17.25 235 N/A (124.962) (30.48) (420.18) (71.11) (109.9) (60.9) (15.2) (43.8)2 (106.59) 50ES* 50 140,100 151 160** 1.00 1.50 1.50 52.00 26.00 6.00 13.50 18.50 305 N/A (189.27) (41.03) (571.60) (71.11) (132.1) (66.0) (15.2) (34.3) (46.99) (138.35) 51EC 50 152,000 161 (7111) 1.00 1.00 .75 59.00 24.00 6.00 11.00 18.00 305 N/A (189.27) (44.55) (609.45) 049.9) (60.9) (15.2) (27.9) (45.72) (138.35) 72E 67 199,000 212 160"" 1.50 1.50* 1.50* 58.00 28.00 8.00 16.00 N/A 520 N/A (253.62) (58.32) (802.51) (71.11) (147.33) (71.12) (20.32) (40.64) (235.87) 120E 113 155,000 163 180 1.00 2.00 2.00 67.00 32.00 6.00 19.00 22.00 660 N/A (427.75) (45.43) (617.02) (82.22) (170.2) (81.28) (15.2) (48.3) (55.88) (299.37) 361E 91 415,000 443 180 1 00 2 00 2 00 67.00 32.00 9.00 23.00 26.00 1065 N/A (344.47) (121.62) (1,676.94) (82.22) (170.18) (81.28) (22.86) (58.42) (66.04) (483.08) 541E 83 623,000 648 180 200 200 66.00 34.00 10.00 30.50 1290 1310 4.19) (182.58) 2.00 N/A(31 5 (167.64) (8636) (2540) (77.47) (585.13) (594.21) NOTE:32E First Hour Rating=725 Gallons '' ,� *Nipple not included C ul US *3 Optional setting,contact factory O �. ***Weight does not include burner and controls (on selected models) E u T&P valve and brass drain valve factory installed Standard Voltage(all): 120V,60 Hz,1 P Working Pressure:150 psi(1034 kPa);Test Pressure:300 psi(2068 kPa) All Bock products meet or exceed current ASHRAE standards. Warning:Do not install on combustible flooring.Installation should be in accordance with all national and/or local codes. In the absence of local codes,refer to NFPA 31. Caution:The recommended maximum hot water temperature setting for normal residential use is 1207.Bock recommends a tempering valve or anti-scald valve be installed and used according to the manufacturer's directions to prevent scalding. www.bockwaterheaters.com 110 South Dickinson Street Madison,Wisconsin 53703 Toll Free 800-794-2491•Phone 608-257-2225•Fax 608-257-5304 Doc#80014 Rev.2/2020 NICOMEC-02 LMARTINEZ ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYvv)7130/2024 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 C N ACT Ellen Greig ,Acrisure Insurance Partners Services of NY,LLC PHONEA o,Et):(914)937-1230 FAX,No:(914)937-1124 90 S. Ridge Street Rye Brook,NY 10573 E-MAI ,egreig@acrisure.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Merchants Mutual Insurance Company 23329 INSURED INSURER B: Nicosia Mechanical Contracting Inc. INSURERC: 1333A North Avenue,#295 INSURER D: New Rochelle, NY 10804 INSURER E 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [X OCCUR X BOP1085304 5/16/2024 5/16/2025 DAMAGE TO RENTED $ 500,000 erlre)MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY�X JERPT 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,006 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident)X ANY AUTO CAP1064875 5/16/2024 5/16/2025 BODILY INJURY Per arson $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY BODILY INJURY Per accident $ X AUTODS ONLY X AUOTOS ONEDY PPRO PPEER.iDAMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE CUP1001099 5/16/2024 5/1W2025 AGGREGATE $ 4,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- TE ER AND EMPLOYERS'LIABILITY Y/N iSTATU ANY PROP R I ETOR/PARTN E R/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ It yes,descnbe 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) Village of Rye Brook is included as Additional Insured as per policy terms and conditions. I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 938 King Street -- Rye Brook,NY 10573 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NEW Workers' SRK TA E Compensation CERTIFICATE OF Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a. Legal Name and address of Insured (use street address only) 1b. Business Telephone Number of Insured NICOSIA MECHANICAL CONTRACTING INC (914) 804-7069 1333A NORTH AVE#295 NEW ROCHELLE NY 10804-2120 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically 1d. Federal Employer Identification Number of Insured or limited to certain locations in New York State, i.e. a Wrap-Up Policy) Social Security Number 80-0927730 2. Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Hartford Underwriters Insurance Company Village of Rye Brook 30104 Building Department 3b. Policy Number of Entity Listed in Box"1a": 938 KING ST 76 WEG AC9354 RYE BROOK NY 10573-1226 3c Policy effective period: 05/02/2024 to 05/02/2025 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 "T' insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York (NY) must be listed under Item 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 Worker's 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 1 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: Sara Seier (print name of authorized representative or licensed agent of insurance carrier) Approved by: 07/30/2024 (Signature) (Date) Title: Operations Manager Telephone Number of authorized representative or licensed agent of insurance carrier: (877) 287-1312 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) Form WC 88 31 21 F Printed in U.S.A. www.wcb.ny.gov Page 1 of 2