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Home My WebLink AboutBP25-164SECTION /t SLACK % LOT / TYPE OF WORK a 91i 7%e-�7uv7k i � ion SS2 Q oiay2 JOB LOCATION 31 174fr/I047&0ve701,6Q ✓�v® oie e A fly OWNER //Q© ✓► S%sccl i S TLC 9/1 ate► 1 mg an44ioC9/49)74Y-9003 rc® FEE oATE DATE INSP FOOTING FOUNDATION FRAMING RGH FRAMING . la L W�04INSULATION 10`7'i PLUMBING RGH PLUMBING /o- GAS 1:3 SPRINKLER ELECTRIC700 'r LOW -VOLT HY3 ALARM ' AS BUILT C3 FINAL OTHER APPROVALS ARB BOT PB ZBA OTHER Mea y rcorJ541 c ryl VILLAGE OF RYE BROOK WESTCHESTER COUNTY, NEW YORK NO: 25-148 Certificate of (9ccupaucp This is to certify that Ilao kir) q OSSveta�eS" L of, /V J , having duly filed an application on Yeberc:2f. 20t ,-5 requesting a Certificate of Occupancy for the premises known as, I f1-lerra-fiD17a/ Rye Brook,NY, located in a o8-I Zoning District and shown on the most current Tax Map as Section: k;27• U / Block: � Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. "/(!1 , issued -7 o� 20 v , 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: 46U Construction: , for the following purposes: Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: 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 kbuildingfthe facilities shall be made, and no enlargement, whether by extending on any side or by increasingin hhall the building be moved from one location to another until a permit to accomplish such change haBuilding Inspector. Building Inspector,Village of Rye Brook: Date: DEC 0 2 2025 �yEDR 4, t . 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.Qov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 2,2025 1100 King Associates LLC 4 International Drive Suite 300 Rye Brook,New York 10573 Re: 3 International Drive, Rye Brook,New York 10573 Parcel ID#: 124.81-1-1 Mechanical Permit#25-131 issued on 8/20/2025 for Fire Sprinkler System Modifications This certifies that the fire sprinkler heads,installed under the above captioned permit,have been satisfactorily completed. Sincerely, *;— 4 Steven E. Fews Building&Fire Inspector /to 4R' k -G oGta,�, �J� (.G . 19 wy, VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J.Bradbury xv vw r-ebrookny.go TRUSTEES BUILDING& FIRE INSPECTOR Susan R.Epstein Steven E.Fews David M.Heiser Donald T.Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 2,2025 1100 King Associates LLC 4 International Drive Suite 300 Rye Brook,New York 10573 Re: 3 International Drive, Rye Brook,New York 10573 Parcel ID#: 124.81-1-1 This document certifies that the work done under Mechanical Permit #25-139 issued on 9/2/2025 for the modifications to the existing HVAC system has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BUILDINdf TMENT For office use only: PERMIT# NOV 21 2025 VILq�E OF RYE U-jj�OK ISSUED: 938 KING STREt I YE BROOK,`N-Fw YoRK 10573 DATE' 21 2<— 9 -06 Uj' FE PAID w�vv l• 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 ####►#ii##R####RRiiti►►i#kk►►R►RiRk#}rt##}i#i##rtrt}#if}f#rt}}#rt►#iititii►iit►##kfk#Rffff#f}i}#irtf##ik}f#}t##i}######►i►►##RiR►t► Address: _3 S t&40�, ,2 Occupancy/Use: Parcel ID#: /p? Zone: Owner: I L12 lctZfA �L�' _ Address: 6AI �� ,��,r��(� � P—6 4-)V P.E./R.A. or Contract Address: Person in responsible charger ad 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 YO C TYl�OF W STCHESTER as: kCC l ��..J.' S• ft.{-L. being duly sworn,deposes and says that he/she resides at� /M��T)A— (Print Name of Applicant) (No.and Street) in 4 �'~F— , r/ ,in the County of WcSTL*ue in the State of-,that (City/Town/ illage) 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:$ , Uv for the construction or alteration of: 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§250-10.A.of th Code of the Village of Rye Brook. Sworn to before me t 's Sworn to before me this day of 0 day of Yna d&I , 20 2 ) ignature o roper y Owner Signature o pplicant -slaw 4W*J, &,crs Print Name of Property Owner Print Name of Applican Aaa1Z,tX\ _ , Notary Publi Notary Public iWA SUMMA NOTARY PUBLIC STATE OF NEW YORK WESTCHESTER COUNT`' 6/t/2024 LIC.# 1S 14 COIAM.EXR ___-- 4Rnv� o y W � >� l9a2 -�� ME BUILDING DEPARTMENT N U BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑ VILLAGE ENGINEER 938 KING STREET RYE BROOK,NY 10573 ❑ CODE ENFORCEMENT OFFICER (914) 939-0668 FAX(914) 939-5801 - - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - - ADDRESS: DATE: PERMIT# ISSUED: �.'t� t� SECT: BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION 0 SITE INSPECTION REQUIRED 0 FOOTING r t ❑ FOOTING DRAINAGE 0 FOUNDATION 0 UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING Q, ❑ ROUGH FRAMING ❑ INSULATION 0 NATURAL GAS A'Lj ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBLING FINAL _-- OTHER r '� V VI BUILDING DEPARTMENT 11.1)IN(: INtiPtil;'1.ON SISTANT•BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street . Rye Brook, NY 10573 (914) 939-0668 FAx (914) 939-5801 www._��bro�k.o'rg - - _ _ INSPECTION REPORT - - - - - - - - - - - - - - __ _ - - - _ Al)i)KEtiff ;3 PERMIT# k �O r t V --„ ISSULsl):��2/�t)r dd LOCATION: �tal ^ItucS@'v�lc.,� _.__.....___� OCCUPANCY: ❑ Violation Noted THE' WORK IS... MASSED ❑ FAILED REINSPECTION ❑ SITE. INSPECTION REQUIRED ❑ FOOTING ❑ 1"00TING DRAINAGE. ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROU(-Il PLUMBING ❑ ROUGIt I"RAMING ❑ INSULATION ❑ Natural Gas At ,WV ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ (,ROSS C;ONNIiCTION ---w ---- ❑ FINAL O �� w � -c 198-2 BUILDING DEPARTMENT ❑BUILDING INSPP.C'1'OR 2<S-SISTAN'r BuiLDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE:t:NFORCEM1iNT OFFICER 938 Kin} Street • Rye Brook, NY 10573 (914)939-0668 FAx (914) 939-5801 www.��ir�k.c�rl; - - - - - - - - _ -- - - 3 ADDRESS : `'� w ! J,+ l ✓+Q, ____......_....__ DA L: Z.cb_ 7-0z' ISSUED:.._ ,Q LOCATION: p?nJ OpZ, �Qu 14/ ,S5041y OCCUPANCY:_ ❑ Violation Noted T111( wolm Iti... PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas 'E.v ✓ L C. tilet� �j ❑ L.P.Gas LZ ` ❑ Fum,TANK V ❑ FIRE?SPRINKLER ❑ FINAL PLUMBING ❑ GROSS CONNECTION - ❑ FINAL. �)'1'EEIiR I �f ��yE 4Rnv�. Village of Rye Brook Building Department-Inspections O 938 King St Rye Brook,NY 10573 1 Phone:(914)939-0668 Fax:(914)939-5801 ROUGH PLUMBING Permit number: RB25-0046 Permit type: Plumbing—Remodel—New Fixtures and Lines Municipal address: 1100 KING ST Legal address: Status of inspection: Active Issue date: 10/08/2025 Deficiencies DISCOVERY DATE COMPLIANCE DATE REFERENCE DESCRIPTION NEED TO SEE ALL WATER LINES INSULATED,PVC PIPE ON SHOWER 10/16/2025 DRAIN IN LOWER LEVEL CEILING COVERED WITH PLENUM WRAP MATE RIAL,FEW HANGERS REINSTALLED,COPPER WASTE LINE CAPPED IN CEILING BY COLUMN. Visits VISIT DATE INSPECTOR VISIT RESULT SITE CONDITIONS 10/16/2025,1:30 PM Alfredo(Freddy)DiVitto Inspection not complete +19149390668 Alfredo(Freddy)DiVitto NEED TO SEE ALL WATER LINES INSULATED,PVC PIPE IN LOWER 10/16/2025,2:30 PM +19149390668 Passed CEILING WRAPPED WITH FIRE RATED PLENUM WRAP,A FEW HANGERS REPLACED,COPPER LINE CAPPED IN OPEN SPACE. Parties NAMEANDCOMPANY CONTACTROLES Tanyia Summa 6 International Drive,Rye Brook 12100 King Associates LLC +19146941090 Property owner Chris Cannizzo 523 Commerce Street,Hawthorne Grotto Plumbing Inc. +19144766659 Applicant,Plumber Licensed Professional ��yE t3RC>>k w � Y BUILDING DEPARTMENT � `'❑BUILDING INSPI:(;'1.OR +p nti31tiTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE,1'.NI;ORCGMIiN'I'()f•I-'ICI?R 938 King Street • Rye Brook, NY 10573 (914) 939-0668 FAx (914)939-5801 www.rn rouk.org - INSPECTION REPORT - - - - - - - - - - - - - - - - - - Z ADDKI:titi :�J /�V IOa 1 1/ (. DA 1 1.: 1 l`� -7 PERMIT'# 6p 1SSUIiD:7-Z/-ZS11 t "1 : IZy S BLOCK: / LOT: LOCATION: ✓C Floa L- (:Y q,-J es$e,,4 I0 OCCUPANCY:__ 0 Violation Noted THE WORK IS... PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE: ❑ FOUNDATION 0 UNDIiRGROUND PLUMBING NOTE'S ON INSPECTION: ❑ ROUG:11 PLUMBING ❑ ROUGH FRAMING: INSULATION ' I ❑ Natural Gas l�(J(s'4 (.�.�f-L.» � Q �.L /^+ ,��ol. lw�C�le, k, ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL. PLUMIIING -- ❑ CROSS C:ONNI:C.rION - -(I FINAL FINAL ❑ OTIII?R __ C (3k(�k• O y� ❑IIUILUINGNG INsI►1•a;'1'OK' BUILDING DEPARTMENT Q<SSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑C(11)1:ENFORCEMENT OFFICER 938 King Street • Rye Brook, NY 10573 (914) 939-0668 FAx (914) 939-5801 W W W.rycbrook.org INSPECTION REPORT - - - - - - - - - - - - - - - - - - - ADDRIiss : ,� �'v•4t��o.�k 1�aJC L z1 tO "7 — _.......... I?ATE: PI?ItM17'Jl 80 25^- l�p `-' I.titi� i u:7-Z/-Z��ii ( I: 12 I• c`3( BLOCK:_ LOT:_1_1.._.._ l,OCATION: F LowQ- 6?'-A 1 Q T S5e,4 C OC(.UYANCY: ❑ Violation Noted THE WORK IS... PA.SSI:D ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ 1-00TING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTUS ON INSPECTION: ❑ ROUGH PLUMBING ,I "lloUGt1 FRAMING ❑ INSULATION ❑ Natural Gas At LL QLL ❑ [..f� Gas ❑ FUEL TANK -- ❑ FIRE SPRINKLER ❑ I-INAI. PLUMBING ❑ CROSS CONNECTION ❑ I"INAL a ��„� N N .. .O ❑ a � � v � 1©-1 a � cpa•`� O W e F v v U W W � `J A. Qj Nu MITI � v o f C v U 00 � 11 Q� 1`--1 W 1~1 a O a �• p x '� � � M W � o � � a.• cfi `J 0 M .aN W " w•° 3 V W ooCIA cr 0.4 V--4 A 4 z T ,°o aka Get �h �Cj7 a O U3Q M o a W O v � VU lul Z M W C7 o � � o �. A w a a � c. o,v e a BUILD 1VIENT r V11L E OF R QOK D 938 KING ET RYE Bllz ,NY 1057 jUN 2 6 2025 4 -0 ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPL FOR OFFICE USE ONLY: ``1 � t Approval Date: JUL ' erm pplication Fee:$ Approval Signature: 4 Permit Fees:S Disapproved: Other: Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit forthe interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address:3 ,"ix a/..&1i� SBL:,,�N. — l Zone: 2. Proposed Improvement.(Describe in detail): 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER I: TIER 1I: TIER III: 4. 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 I Hood,etc...) :No: Yes. (If yes,please submit a separate Automatic Fire Suppression System Permit a plication&2 sets of detailed engineered laps) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: l -After Construction: a 6. N.Y State Construction Classification: N.X.State Use Classification: 7. Property Owner: 1100 Phone# ell# 8. Applicant: Address: Phone# AA Cell# email: r 9. Architect:m rlk Address: Phone# 0_6 ` L/:�7-3 9 Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: Address: Phone# Cell# email: 12. Estimated cost of construction $ (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: (1) 6/l/2024 BUILD MENT VIL E OF RY OOK 938 KING ET RYE BR NY 10573 w ov 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 j�OF NEW YORK,COUNTY OF WESTCHESTER ) as: Q I, •�.!�t IC I&4w ,residing at, {Print name) l:4Jtir. i, lien) 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; 3 )wp:R+►wy*A. : gig &W ?3 , Rye Brook,NY. 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. 12& Cc,S � (Signatureo rol7crty(Av, (s)) w• qS cp 6-ct& (Print Name of Pngperth O�%n.,,- Sworn to before me this�( day of , 20 r TAWiA SUtr1 M t4OTMY PUBLIC STATE CHEM Y021K tN ,i:e, Puhi LIC 2W:214 (2) 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. ,S �OF NEW YW�� TY OF WEST ) as: lL��( 1 being ing duly y sworn,deposes and states that he/she is the applicant above named, (print name of individu sagmng as a applicant and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the _&v,Fr _ 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 Fire 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. 4 4dayof o b fore me this Sworn to before me this Cl1 © day of , 20�rCJ- �U` of erty Owner Signature o Iicant WSYLo&� 4TJMA 6cs UV• :S Gc s 44-C Print Name of Property Owner Print Name of Applicant Notary Pub is Notary Publ c _... ._�_TA4Y A SUMA N07,ARY PlJB_IC cgATE 0 ,?,jcU'!yC.q WESTC HEATER CoLl")"i1Y LIC. P, 3U 2214 CCU(UP (a) 6/l/202a CV N N W N N N \ \ e W00 .�- W 00 oG p oe u 6- �' Q w N x S W v f u F cn - aA C • o Q ,�- PL., ao 00 Ln SIN z fF—I V �: Q cr, r° w z F O z . Z a3 z � ZV w o a M z w w z A oA a z w A ax �I ~ ° U ., w a z w = � BUILDING DEPARTMENT VILLAGE OF RYE BROOK AUG _ 6 2025 938 ICING STREET RYE BROOK,NY 10573 (914)�r0668 I VILLAGE OF RYE BROOK NNrWW.ryehtookn .gov PjILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: _ EP#: Approval Date: N\ Pe ee: $ 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, s 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. L Address: � �/1/TINIV4`�Ld rt/�0 al 'Dr', SBL:L d Y, Q— Zone: 2.Property Owner: J kO 0 16.75 q SS QC4 Address: Phone#: Cell#: email: 3.Master Electrician/Licensed Installer:'T19'iVI{,S AeiW Address: 5S 1Uf" ' � B�A114"A0 -y to Lic.#: l'7J Phone#:a u!-K Z d'-10 fV Cell#: ��1FS/7- J l/ email: e Company Name:�g {�+ri 1 -Address:-) 2g e S S n r - 4.Proposed Electrical Work/Fixture Count: �' i�B r�vwdoa Ny F..r,r,i-r a '0 Rove , D✓;ce1K ��r rra LDS I�T.N.9 lc9�J sFiro L 5.3rd Party Electrical Inspection Agency:'e-V STATE OF NEYV YORK,COUNTY OF WESTCHESTER ) as: Z:S'AWeS 94,(/ being duly swom,deposes and states that he/she is the applicant above named,and does further (print name otindividual si151 L an Le applicant) state that(s)he is the . S_ for the legal owner and is duly authorized to make and file this application. aster Electric[. n.ct installer) The undersigned further states a a statemen on med 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 v Y ,20� Signature of Property Owner Si e of Applicant Print Name of Property Owner 4OXYTOrK of Applicant Notary Public LuannNotary Public, Sta No. 01 NE6020203 6/1/2024 Qualified in Westchester Cour>ty Term Expires March 1,20 ��7 STATE WIDE INSPECTION SERVICES, INC. Service With Integrity 0•0 • • SWIS JOB APPLICATION tel 845.202.72240. • Office Use Elect. Permit# Date � /— J� w / - O — lr 7 t` Bldg Permit# �� _ SqR Plumbing Permit# Final Certificate# City/Villages �? ±� Zip D ; Building Dept. ��, �roo County Address �•1 Cross Street Section Block Lot Owner Name/Address off different man above) 'A I Contact Number I f—Jz ❑Basement ❑Ist FI. ❑2nd Fl. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch ley SERVICE Amperage #Panels 1P 3P # Meters #Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# El 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 C t/7 lL S L In T! S vN c.v C�[E + f i tl f— t r i RIE WE DD LAUG6 VILLAGE nF 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 anytime 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 !j I C . e'c ;'0 Name License# Date Signature Address city/State Zip Code / Company Phone# P � , 7- D E C (� �� State Wide Inspection Services L`� 1080 Main Street Fishkill, NY 12524 U t NOV 2 Q 2025 845 202-7224 Phone IV WV914-219-1062 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: Healy Electric Contracting Inc Kingsbrook Office Park 1 Zeiss Drive Quintessential Mortgage Group Thornwood, NY 10594 3 International Drive Rye Brook, NY 10573 Located at: 3 International Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 25-216 124.81 1 1 Certificate Number: 2025-6534 Building Permit Number: BP 25-164 A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 3 International Drive, Rye Brook, NY 10573 The Second Floor Other:Conference rooms, and break rooms were 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 awe compliance on the 20th day of November 2025. Name Quantity Rating Circuit Type LED light Fixtures 89 lam" Exit Signs 09 Wall Dimmers 30 Duplex Receptacles 33 GFCI Receptacles 04 Floor Receptacles 06 VAV boxes 14 Electric Water Heater 01 Heat Pumps 03 Exhaust Fans 02 Name Quantity Rating Circuit Type Smoke Detectors 50 Heat Detectors 01 Relay Module Security Door 01 Horn/Strobes 06 Strobes 07 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. Page 2 1 C T ° ❑•, r7 Q ` � r i y N ° Y L i�' �• O O Oh� YO O T u Er E a c v c L ` fo LL r) v c�$ E L � c a a4 'o a� E Q) L N m W m F c aai } a 3 a w vtv LL O w ~ o a o w N , c m y `° r > v F- Q� CD O ui u v 3 c +J Wry Ln N O 2 N 3 ° y ^ L O F- Z 3 2 mo a ou aZ c o C-) Eo1uj W W o 'ta F- �Oy �oE °Q N O Z GJ J 3 a CO a O O O c a E m J QJ } o c - w O J W 3 J V1 A — ra ° E .. 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C � z CY) L y �[ � W li � L u 3 LLY � a00 W0 � v 0 -0 (U a>) O � O`LLI a` r-A O N Cl) d , Zi tx m O > Cn < O N C ° a+ Q Ln >- O o 0 v Q LL O _ .J c v rya > � Lr) s Z W > S a' - w Q) (D r+ O u — v m � ZZ .-+ E N O W } ac V) 3 o - c 0- Y o o � m `n p ao ; � 3 m' \ O � > O v = U Q7 X v v .� N c4 wH O � > -C (� L� •� •H a p 00 rj N o � o ` ° U N :.co u £ a -a a c u+ v .. o o a� a E LLJU — m N M> a VE 0 ° � � ` o c E w yO Q p m a E W v C W J W co O p } av (D u y LLJ a Q a a 0 a -r � L Electrical Permit Application Village of Rye Brook 938 King St Rye Brook, NY 10573 Phone: (914)939-0668 1 www.ryebrook.gov Building Department Project Information SBL Zone 124.81-1-1 Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency 144 low voltage data cables SWIS Master Electrician/Licensed Installer Information Name Lic# Address email Phone# Cell# David Summa 3 International Dr-1100 King St dsumma@telworx.com 914 934 1338 914 9341338 Company Name Company Address Telworx Communications LLC 800 Westchester Ave Ste N347 Rye Brook NY Address of Work? Homeowner Information 1100 King Associates. LLC. Electrical Permit Application,page 1 I 1 �y BPR VILLAGE OF RYE BROOK 7' 938 King St Rye Brook NY 10573 w Q Phone:(914)939-0668 1 www.ryebrook.gov ��• 1902• i Building Department Electrical/New Fixtures And Wiring(Remodel) Permit Permit Set 1100 KING ST P#RB25-0096 R#124.81-1-1 PERMIT INFORMATION Address Permit number Date issued 1100 KING ST RB25-0096 11/03/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Steven Fews stevefews@ryebrook.org INSTRUCTION AND ATTENTION It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection. TABLE OF CONTENTS Cover page 1 Building Permit 2 Required Inspections 3 Contractor's Workers Compensation Insurance(Showing Rye Brook Cert Holder 4-9 Contractor's Liability Insurance 10-11 Electrical Permit Application 12 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 BRnu� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W � Q Phone:(914)939-0668 1 www.ryebrook.gov > �O ��• 1962• i Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSI BLE FOR ENSURING THAT ALL REQUI RED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE Ell .❑■ REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. Rough Electric Rough Electric Final Electric Final Electric Client#: 1362961 TELWOCOM ACOW. CERTIFICATE OF LIABILITY INSURANCE D 10/17'DD!Y0/17/2025 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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER N ME: Donna Vole USI Insurance Services LLC PHONE 855 874-0888 X A N . A N 8565335742 1433 Hooper Avenue,Suite 110 E-MAIL donna.vol2@usi.com INSURER,Sj AFFORDING COVERAGE NAIC It Toms River, NJ 08753 INSURER A Travelers Property Cas.Co.of America 25674 INSURED INSURER B:Travelers Indemnity Company of RI A18674 Telworx Communications LLC INSURER C:Charter Oak Fire Insurance Company 25615 800 Westchester Avenue INSURER D.New Jersey Manufacturers Insurance Co. 12122 Rye Brook, NY 10573 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 NAMFD ABOVE FOR THE POL ICY 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 A,L THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE DOL UBR POLICY NUMBER MOLT vE VF PMII vExP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY ZPP16P8146025 D4 01,2 26 EACH OCCURRENCE i 1,000,000 CLAIMS MADE U OCCUR ROAR a,:r=0NC=-,:"LA-rCA i 1 Mo,000 AHED EXP jAny one pe,wri $1 O 000 PERSONAL 6 ADV WdURY 0,000.000 000.000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s2,000,000 P40 POLICY[:XCPRODUCTS COMP OP AGG s2,000,000 JECT �LOG OTHER i D AUTOMOBILE LIABILITY 1107694622 9/09l2025 09109/202 COMBINED SINGLE LIMIT 11,000,0(w ANY AJTO BODILY INJURY IPe,person, $ AWNED SCHEDULED BODILY INJURY,Per acadw. $ AUTOS ONIv AUTOS X AUTOS ONLY X NON OWNED PROPERTY DAMAGE $ AJTOS ONLY $ B X UMBRELLA LIAB OCCUR EXIY81520525 04i01,12025 04/011,2026 EACH OCCURRENCE EXCESS LIAB CLAIMS MADE AGGREGATE SCSInn aY0YY00 _ _. DEC I X1RE1kNT!QNS10,000 WORKERS COMPENSATION , PER C UB2Y4260742515G 9/09/2025 04/01,202 X AND EMPLOYERS'LIABILITY AN PHOPRIFTORPARTNER.EXECUTIVE V N E L EACH ACCIDENT 0-0 0 0 000 OFF.CER MEMBER EXCLUDED' N r A (Mandatory In NH) E L DISEASE EA EMPLOYEE $1,000,000 II yes.desc�09 under DE RIP'I F PERATI N E L DISEASE POLICY LIMIT 1$1,000.000 A Leased/Rented Equ ZPP16P8146025 4,,01/2025 04/01/2026 $110,000 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES tACORD 101.Addluonal Remarks Schedule.maybe attached it more space is redu red) Workers Comp Information " Proprietors Partners,Executive Officers/Members Excluded: Michael Franklin, Ot Michael Franklin, Ot CERTIFICATE HOLDER CANCELLATION Village of Rye Brook SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook, NY 10573 AUTHORI2ED REPRESENTATIVE 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016 03) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S51369986 M50583787 APAZP NE Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured 914 761-7600 Telworx Communications LLC 800 Westchester Avenue 1 c NYS Unemployment Insurance Employer Registration Number of Rye Brook NY 10573 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 26-1768133 2 Name and Address of Entity Requesting Proof of Coverage 3a Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) The Charter Oak Fire Insurance Company Village of Rye Brook 3b Policy Number of Entity Listed in Box"l a" 938 King Street Rye Brook, NY 10573 U82Y4260742415G 3c Policv eff09 ii 65,5, d 4/1/2026 to 3d The Proprietor,Partners or Executive Officers are included (Oniy rhedc box if all partnersofficers 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"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. Donna Volz (Print mine:)f aati-onzedArepresentative or licensed agent of insurance cameri �'Approved by: �0 yci- ' 10/17/2025 is Daip) Title Commercial Line Manager Telephone Number of authorized representative or licensed agent of insurance carrier: 732-908-5554 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are N_QT authorized to issue it. C-105.2 (9-17) www wcb.ny gov STATE WIDE INSPECTION SERVICES, INC7, Service It ith Infegi-iti, 080 • • • SWIS JOB APPLICATION tel 845.202,7224 1 f, Office Use E ect Permit F Date o l All aD aS Bldg Permit u Sq Ft Plumbing Permit 9 Final Certificate# City/Village �119 `�(DCU r Zip 1`� Building Dept County 14\4 C'N `� 1 Address v-�v " 1 'N Cross Street Section Block Lot l Owner Name/Address(v attwent man above) \\t v �,S �t�1�C� LLC Contact Number ,I t _ I`t ! ❑Basement ❑1st Fl. ®2nd Ff. ❑3rd Ff. ❑Mm Than 3 FI. ❑Garage ❑Attic ❑Outside El Residential 1❑l coommercial 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 AL Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation 1l q V^nw v- \4')c (\-oA k Cable_) Ths application n vaW to,one(i)year trom the date receiwd by WAS.This appkAbon is intenaed to c oyet the above listen items to tie inspectea.,tat any time of inspection ackiit ul Hems have been installed,you at, authcmted to make the Mspectton and adjust the fee for the addloonel sent MtspeeW The applicant declares that the—i no open appllcanons for the above address wth any other mspectton company The applicant owner or aumortred agent agree to all the above terms and condtlam m set loft for the apples~ ` Email Address �Ly^^^��, y''��'WOfX \Jrv� Name 1 t SVf—^44,t\ License Of Date \��rg( O�� Signature Address �� r city/State q ti Zip Code Company 2`\Ro 1 v \01 LL Phone r I`,,\ / ( J� REC �� 7 State Wide Inspection Services v 1080 Main Street Fishkill, NY 12524 X0 OEC 3 0 2025 845 202-7224 Phone 914-219-1062 Fax STATE WIDE INSPECTION SERVICES Email: officeCabswisny.com VILLAGE OF RYE BROOK Website: www.swisnv.com Service With Integrity PI II' BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Telworx Communications LLC 1100 King Associates, LLC 800 Westchester Avenue N-347 3 International Drive Rye Brook, NY 10573 Rye Brook, NY 10573 Located at: 3 International Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: RB25-0096 124.81 i i Certificate Number: 2025-9190 Building Permit Number: A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at:3 International Drive, Rye Brook, NY 10573 The Second Floor 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 3RD Day of December 2025. Name Quantity Rating Circuit Type Low Voltage Data Cables 144 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. � o ❑� ¢rP' NO C a N ` j \ 0 o 0 0 +� o � E � OL vim = a.aq v L k v v ii > Q o � c Cl. CL v N °•J' v E o LLI m` c m CC L a m Ln a 4) v � v LL 0 w `� E m 1 L N 2 Z O W u ^ -00 s W � W F- L Y = _o _ � 3 0v � Y F- Z 3v � o Q } N J QO '0' to � a3, a ao N J >. � LL ulYY Q) O Ln ch LUw a 0 °c `oc O 0) Y O Lr) $ 1 o� O � ^ 0L- 20 W > v3z o � �E00 0 3 Ln = �a� F- Eocy °' o } L Q c Z N $ Q ai c f0 0 m a' bA O > u m > 'C a` E +, O � j m Q a Yw — Q �W o YV) c O � Z N � � �-6 > Owe 0 m �, L U aQw E mc ° cC `O V) L O ' ;.1 g pcomEa O %0 V) a C 4J n o v W a to O o CV tB >' U-) d w u m m u d� a c- a� Z p W ` v o o c w 04 W } ZC)M. C') � > cry LL OD ° O W O °° U o v w Q) 00 a1 �/ w c-1 m Ln o w v E O c) a ./_� o � � a a, z � � tLU o LL CL a) O r- Q c vi c C v C c N } N W UQ E E w E J v °°0 3 L = R _ _ t O u N O F- F m � r, 0 .° a ' N E 'N v N E O > 2 > imp U E � c E .. `if v 0 o0 Z Z 5 C L C W } c (A � = c �o a a m E o c as 0a � o � � 0 C) � ° LAU4- c "—' u ;zza vim' i O 04 a � tN u F=- Q 6= o L v - O r, N wan � � > s In .� c-I c i - c ._ a C7 U �n 2 � � C�j o .. o L ° N E °c 'N0v � E W o a (U > r , (U V 0m ° ooc` a ^^ c o oo `` C� \V 1..� 0 = E Ln vQ, mE aa),.E� N a Q( 00 °c J LLI O } W `o o O U F- cOL � � 0 Z ' n C, 0 LLI a 0a � vL Plumbing Permit Application Village of Rye Brook 938 King St Rye Brook, NY 10573 Phone: (914)939-0668 1 www.ryebrook.gov Building Department Project Information SBL: Zone: 124.81-1-1 Proposed Work: (Attach to Building Permit BP-25-164) - Rough Plumbing &Setting Fixtures for(2) Bathrooms, (1) Pantry , (2) Water Heaters ((1) 20 Gal.& (1) 10 Gal.) Indicate Fixtures&Lines to be installed as per the following schedule: 1st 2nd 3rd 4t6t Other gttWipment/Provide Details: FIXTURES Basement Ex�e for Floor Floor Floor FkMp Punf} KAtH1 &WH�1 -will provide Submittals Water Closets 2 Urinals Drinking Fountains Sinks 3 Showers 2 Bath Tubs Laundry Tubs Domestic Service Fire Service Sanitary Sewer Natural/LP Gas Other* 3 TOTAL 10 Plumbing Permit Application,page 1/1 ��yE aR�uk VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 0 0 QPhone:(914)939-06681 www.ryebrook.gov 19b2 Building Department Plumbing/New Fixtures And Lines(Remodel) Permit Permit Set 1100 KING ST P#RB25-0046 R#124.81-1-1 PERMIT INFORMATION Address Permit number Date issued 1100 KING ST RB25-0046 10/08/2025 REVIEWED BY If you have any questions regarding the review of these drawings please contact: Application in general Alfredo(Freddy)DiVitto adivitto@ryebrook.org INSTRUCTION AND ATTENTION It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection. TABLE OF CONTENTS Cover page 1 Building Permit 2 Required Inspections 3 Plumbing License-Photo-Westchester County 4 Application Materials 5-31 Property Owner/Homeowner Government ID,and/or Proof of Ownership 32 Plumbing Permit Application 33 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 �Py BR(�uk VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 Q Phone:(914)939-0668 1 www.ryebrook.gov 19(}2 '� Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE R1 .❑0 REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. 01 TRENTA LACAVA freestanding toilet GL58 Specifications: Installation: Freestanding Dimensions: 14 3/8"w x 28 5/8"d x 30 3/4"h Material: Porcelain Flush System: Dual flush Waste Outlet: Floor Bowl Shape: Oval Trap Diameter: 1 7/8" ID, 3"OD Water Use: 1.0 gpf Weight: 112 lbs 4 Finishes: 001-White 14 365 Features: +78rt- • ULTRAGLOSS finish for easy-cleaning, stain and odor resistant ILL • Includes mounting hardware • Installs on a standard toilet flange with 6" bolt distance • Soft-closing seat cover and tank are included • Porcelain elongated one-piece toilet zs s/s" • Glazed internal trapway 727 • MaP performance (Miso Rating): 1000g miso 14644 • Low consumption dual flush system -effective flush volume: 1.0 gpf I U —--- 13 5/8" 346 3/4„ 19 Codes + Standards: • Meets and exceeds applicable national codes and standards • CAL-Green compliant �er$� • CEC compliant . compliant when installed to specific requirements of this regulation 78 /�r•rO RSL 161/2" NC�T 419 Recommended Items: • GL58CW: Replacement seat cover Outlet diam.��— 12 ID:2" 305 • GL58-FV: Replacement flush/fill valve and button kit OD 3„ LACAVA reserves the right to revise any dimension or information on this sheet without notice.Dimensions are nominal and may vary within an industry accepted tolerance of 1/4". Drawings provided herein are meant to give the user an Idea of the product and are not made to scale.Location of plumbing is meant for reference,your specific application may vary. Revised:07/06/2020 LACAVA I CHICAGO, IL, USA 1 773.637,9600 1 INFO@LACAVA.COM I LACAVA.COM oz LACAVA KUBITOP KBT-ADA-30 19 30 17 5 / 15- 22 1 1 CALIR AMA ADA REQUI EMENT + r �} k N 4 I' 29 1/2 ^ FEDERAL AAA REQUIREMENT SUGGESTED PLUMBING I' 21 3/4 LOCATION WHEN USED WITH K30 Recommended installation height "Recommended plumbing location FEATURES: FINISHES: WALL MOUNT VANITY WOOD: CAN MEET FEDERAL ADA REQUIREMENTS WHEN STANDARD: PREMIUM. LUXURY: 6-DRIFTw000 02-NATURAL CHERRY 22-GRAY ZEBRA 37-WEATHERED OAK NEWTERRA NO INSTALLED CORRECTLY 07-NATURAL WALNUT 31-WHITE OAK 52-SILVER OAK 24-CLASSIC WALNUT 27 RUSTIC 50-HORIZON BLUE TWO DOORS WITH SOFT-CLOSE HINGES 20-ASH GRAY 47-SMOKY WALNUT FINGERPULL OPENINGS 33-WENGE-AFRICAN 08 MATTE WHITE 85-GLOSS WHITE METALS: USED WITH K30 VANITY SINK TOP(SOLD SEPARATELY) MAHOGANY 35 MATTE ARDESIA 88-GLOSS ARDESIA METAL: 54 MATTE TAUPE 84-GLOSS TAUPE 21-BRUSHED STAINLESS STEEL MOUNTING:FRENCH CLEAT(INCLUDED) 16 MATTE BLACK 86-GLOSS BLACK 10 POLISHED STAINLESS STEEL 47 MATTE OLIVE GRFFN 87-GLOSS OLIVE GREEN (SEE FURNITURE MANUAL) 39-MATTE SAGE 4A-MATTE BLACK 28-MATTE AZURE MW-MATTE WHITE -PROUDLY HANDMADE IN THE USA 29-MATTE CLOUD BPW-BRASS POWDER COAT MANUFACTURED WITH LOW VOC FINISHES 40-MATTE ZEST SA SIENNA AND WOOD rROM RCNEVyABLE FORE3T5 COUNTERTOP' STONE. QUARTZ: SOLID SURFACE' CONCRETE: Wit-BIANCO PR PURO M-SATIN WHITE SND-SAND BRK-BRICK U1 L!NAC AH-ASH G POLISHED WHITE SLT SLATE MAH-MATCHA AN-ATENA CT-CRETA R MARMO SUN-SUN GAL-GALAXY VN-VENA V LAVA CLY-CLAY TER TERRACOTTA DN DUNE D-OBSIDIAN LIL-LILAC CHL-CHARCOAL NR NERO C-CREMA MOS-MOSS BST-8ASALTO AQA AQUA I ACAVA reserves the right to revise any dimension of infoi motion on this'hers l w1 hout notice M-ensions ore rominal and may very with.ir o-industry accepted tclelnnca or 1 y_ Cabinolf`.Ill,'�f•Jly ion'Ink•:u . Jc,to in.molpl,ln{J fin♦•an.1.l�.nnnf ion'mnY vary LACAVA,, rot ro pn iblr-I., nv<.irn'.l',n � 1l 1r p. or fi.r thor,mndn wil houl the actual product or template'Dillerem-es in color grain oppearonce and texture ore inherent in oil natural woodwrnk and should bo expected.Vorionces it) thoso qualitles are not deemed monufack-ring defects and,vill nol be ocr.eoteiY a'valid reasons for return or exchanges PlumbMg specificofians are only a guideilna nail may need niteration based on oonlication 6630 WEST WRIGHTWOOD PH: 773-637-9600 LACAVA.COM CHICAGO,IL 60707 FAX:773-637-9601 INFO'9 LACAVA.COM 03 LACAVA zoom Specifications: deck-mount electronic faucet Installation: deck-mount 1-hole,touch-free EX 10A/EX 10A. 5/EX 10A. 3 5 Exterior Dimensions: H: 6 3/4"SPOUT:5 3/4" Material: solid brass construction Water use: 1 GPM (EX10A),0.5 GPM (EX10A.5),0.35 GPM (EX10A.35) Power supply: AC/DC Finishes: CR-polished chrome PN-polished nickel NI-brushed nickel (�f BG -brushed gold �! 44-matte black TN -titanium `�_ ��+•. Cutout Size: 0 1 3/8" Accessories included: power adapter, flexible supply Features: line F 1/2"and battery box ' r .. . .- - • Power supply options: AC -transformer with a plug to electricity and/or DC - battery pack for 4 x AA alkaline batteries • touch-free safety from (batteries not included) spreading pathogens - on average lasts for 108,000 use cycles p g undesirable atho ens • For cold or premixed water(mixer sold separately) 1� commercial grade automated fixture 10 seconds metering cycles low flow promotes water use savings • Sensing distance by default: 8" (20cm) Sensing range: 2"-12" (5cm - 30cm) adjusted upon request 53/4" _013/4" Sensor life expectancy: 500,000 cycles 146 T Water pressure: 15-90 PSI, recommended 43.5 PSI Water temperature: 34-120' Fahrenheit (1-50' Celsius) • No reflective surfaces (mirrors, polished metal finishes, 63/4" etc) to be placed in the range of the sensor 170 2 Codes + Standards: 58 1/4" I .,, 0 " ASME A112.18.1/CSA B125.1 102 50 Max 1 1/4" • NSF/ANSI/CAN61 2" t 30 • NSF/ANSI/CAN372 5o /g" 4 7/8 Compliant with California AB-100 35 • 1 GPM Watersence certified (EX10A) • 0.5 GPM CAL-Green compliant(EX10A.5) 43/4" +_ • 0.35 GPM LEED Credit(EX10A.35) lzo compliant when installed to specific I o 0 ® requirements of this regulation ys EPA co Recommended Items: • Replacement parts: • #4ABATPK - replacement battery pack • #EX10A-SENR replacement sensor INLET M 1/Z" • Mixing valves(sold separately) • #EX20A -mechanical mixing valve IMPORTANT: Install provided • #EX25A- integrated thermostatic valve flow reducer on the water inlet • American size grid drains • #7100-18-without overflow holes • 47100-18OF-with overflow holes IACAVA reserves the right to revise any dimension or information on this sheet without notice.Dimensions are nominal and may vary within an Industry accepted tolerance of 1/4" Drawings provided herein are meant to give the user an idea of the product and are not made to scale.Location of plumbing is meant for reference.your specific application may vary. Revised:11/08/2024 LACAVA I CHICAGO, IL, USA 1 773.637.9600 1 INFO@LACAVA.COM I LACAVA.COM 04 ARCH LACAVA Minimal Shower Head 0414 Features: • Tilting round rain shower head Brass construction with 60 rubber nozzles - - • Wall-mount installation recommended • Arm and flange sold separately • Outfitted with a 1.75GPM flow regulator, with backflow prevention, Max. flow rate: 1.8GPM • Maximum tilting angle: 19 degrees Finish Options: • CR - Polished Chrome • PN - Polished Nickel • NI - Brushed Nickel • BG - Brushed Gold r 112" • 44 - Matte Black ~ —+ 1 45 • {- 04" + 100 Codes + Standards: • Meets and exceeds applicable national codes • Meets Cal-green requirement • • Complies with CEC standard 'b�ersehs 1 Z E�. i.vuoai+ Recommended Accessories: • Item 440OA: Wall-mount round shower arm with flange • Item #15PB1.L.R: Built-in single-lever mixer with lever handle and escutcheon IACAVA reserves the right to revise any dimension or information on this sheet without notice.Dimensions are nominal and may vary within an industry accepted tolerance of 1/4". Drawings provided herein are meant to give the user an idea of the product and are not made to scale Location of plumbing is meant for reference,your specific application may vary.Revised.11/13/2023 LACAVA I CHICAGO, IL, USA 1 773.637,9600 1 INFO@LACAVA.COM I LACAVA.COM 05 ELEGANZA LACAVA built-in thermostatic valve with 2-way diverter Specifications: 18TH 2 . L. S, 18TH 2S. L.S Installation: built-in wall mount Exterior Dimensions: W: 5 1/8"H:7 1/4" Material: solid brass construction with thermostatic cartridge and diverter ceramic cartridge with 2-way out Water use: 7.1 GPM(43.5 PSI) PA4 Finishes: CR-polished chrome PN-polished nickel I I- NI-brushed nickel BG-brushed gold A 44-matte black Fittings included: 18TH2.L.S non-sharing diverter valve: #VTH2.1-rough-in with non-sharing diverter and trim#18TH2.L.S-A 18TH2S.L.S sharing diverter valve: #VTH2S-rough-in with sharing diverter and trim# 18TH2S.L.S-A L Tile opening max size: W:4 3/8"H:5 3/4" Features: NON-SHARING • unibody thermostatic valve with 2-way diverter and OFF function • lever handles and rectangular backplate • non-sharing 2-way diverter valve with 1801 rotating angle #VTH2.1 OFF • sharing 2-way diverter valve with 3600 rotating angle#VTH2S 90, • 3/4" NPT water in and 1/2" OUT connections (outlet B and C) • anti-scald protection &temperature regulation 90 SON • water temperature set to 100'F UTLET B • screwdriver service stops ON • separate check valves with filters for easy servicing OUTLET • finished wall must be flush with mudguard as marked • 1 1/8" extension kit available + Codes + Standards: a Meets and exceeds applicable national codes and standards SHARING • ASME A112.18.1/CSA B125.1 a ASSE 1016/ASME A112.1016/CSA B12S.16. • CAL-Green compliant(non-sharing valves) OFF compliant when installed to specific o 90, requirements of this regulation 90 ON ON Recommended Items: �OUTLETB • Replacement parts: OUTLET 90, • VD2-C-diverter cartridge, non-sharing 9% ON • VD2S-C-diverter cartridge, sharing OUTLET B+C • R039 thermostatic cartridge • VTH 1.1-EX 1 1/8"extension kit for non-sharing valve • VTH3.1-EX 1 1/8" extension kit for sharing valve IACAVA re.e es the right to rnvise nny dimnnsinn or information on this shset without notice.Dimensions are nominal and may vary within an industry accepted tolerance of 1/4" Drawings prnvided herein are meant to wive the user an idea of the uroduct and are not made to scale.Location of plumbing is meant for reference,your specific application may vary. Revised.7/29/2024 LACAVA I CHICAGO, IL, USA 1 773.637.9600 1 INFO@LACAVA.COM I LACAVA.COM 06 LACAVA ELEGANZA built-in thermostatic valve with 2-way diverter - -- 18TH2. L.S, 18TH2S. L.S 2-WAY OUTLET C 4@0- OUTLET B ---- 4 1/4" -- 5 1/8" — 107 y 130 3 X F 1/2 NPT OUTLET A for 1/2 copper tubing A. 2 1/8" 55 3" OUTLET _.i �L �_ OUTL T8 75 —T— ♦ rssilo- I 3 1/8" 2 X F 3/4 NPT :4 5/8" 2 1/2" 71/4" 78 for 3/4 copper tubing ,_._; 117- 63 185 1 0 HOT COLD _ I 13/8" t + -+ --- 35 3„ Tile opening 75 2.:_,- max size: sQ____- o mudguard 4 3/8"w-5 3/4"h 4 1/8" 111 x 147 105 ---- 2"—� 61/8" 50 156 ------------------------------- NON-SHARING SHARING 21/2" 11/4" 63 30 FINISHED WALL _ max thickness 1 1/2" 1 1/4" FINISHED WALL must be flush with ; this mudgurd 9a 6" 153 3 1/8" 3 1/8" ---- 78 78 1 7/8"5/8' 22 16 1 1/4" 1 1/4" 32 _ 32 +� ; 1[4" 1/4" 2 5/8'. 5 56 65 3 3 5/8" 92 ; LACAVA reserves the right to revise any dimension or information on this sheet without notice.Dimensions are nominal and may vary within an industry accepted tolerance of 1/4". Drawings provided heroin are meant to give the user an idea of the product and are not made to sale.location of plumbing Is meant for reference,your specific application may vary. Revised:07/29/2024 LACAVA CHICAGO, IL, USA 1 773.637.9600 1 INFOOLACAVA.COM I LACAVA.COM 07 ELEGANZA LACAVA Hand-held Shower Head 1861 Features: • Hand-held shower head with fixed jet • Includes 59" flexible hose •...,,i • Hook and hand shower wall union sold separately • Outfitted with a 1.75GPM flow regulator, with backflow prevention, Max. flow rate: 1.8GPM Finish Options: ` CR - Polished Chrome • NI - Brushed Nickel • PN - Polished Nickel . • BG - Brushed Gold • 44 - Matte Black 1 3/8" 1/2_ _�__.__.. ,�_•,__ 35 13 I 9" 230 M 1 2" Codes + Standards: • Meets and exceeds applicable national codes • Meets Cal-green requirement • Complies with CEC standard Recommended Accessories: • Item # 2070: Wall-mount rail with hook for hand-held shower head • Item #1863A: Hand shower wall union IACAVA reserves the right to revise any dimension or information on this sheet without notice.Dimensions are nominal and may vary within an industry accepted tolerance of 1/4•. Drawinas provided herein are meant to give the user an Idea of the product and are not made to scale.Location of plumbing is meant for reference,your specific application may vary. Revised:4/14/2022 LACAVA I CHICAGO, IL, USA 1 773.637.9600 1 INFOOLACAVA.COM I LACAVA.COM 0s ELEGANZA LACAVA ,, com Shower Rail W 1470 Features : • Wall-mount rectangular rail with hook for hand-held shower head • Knob to adjust height and direction of hook • Shower head and hand shower wall union sold separately Finish Options: • CR - Polished Chrome • PN - Polished Nickel • NI - Brushed Nickel • BG - Brushed Gold • 44 - Matte Black 2 1/2" 1 1/8" 3/8" 29 10 27 5/8" 26 7/8" 700 683 Recommended Accessories: • Item#W1460: Hand-held shower head with 59"flexible hose • Item 41473A: Hand shower wall union tACAVA reserves the right to revise any dimension or information on this sheet without notice.Dimensions are nominal and may vary within an industry accepted tolerance of 1/4". Urawings provided herein are meant to give the user an idea of the product and are not made to stele.Location of plumbing is meant for reference,your specific application may vary. Revised-6/19/2020 LACAVA I CHICAGO, IL, USA 1 773.637.9600 1 INFOCa1LACAVA.COM I LACAVA.COM 09 ELKAY Elkay Crosstown Stainless Steel 25" x 22" x 9" SPECIFICATIONS Single Bowl Dual Mount Sink Kit Model(s) ECTSR25229BG PRODUCT SPECIFICATIONS Elkay Crosstown Stainless Steel 25"x 22"x 9", Single Bowl Dual Mount Sink Kit. Sink is manufactured from 18 gauge 304 Stainless - Steel with a Polished Satin finish, Rear Center drain placement,and Sound Guard. Installation Type: Top Mount, Undermount Material: 304 Stainless Steel Special Features: Slim Rim Finish: Polished Satin Gauge- 18 Sound Deadening: Sound Guard Number of Bowls: 1 Sink Dimensions: 25"x 22"x 9" Bowl 1 Dimensions: 22-1/2"x 16-3/4"x 9" Drain Size: 3-1/2" 89mm Drain Location: Rear Center Minimum Cabinet Size: 30" Included with Product: ECTSR25229 sink, Mounting Hardware: Part#64090022 included for top CTOBG2115SS bottom grid mount installation for countertops AMERICAN PRIDE. A LIFETIME TRADITION. thicker than 3/4"(19mm)up to 1-1/2" Like your family,the Elkay family has values and traditions that 38.1 mm thick endure.For almost a century,Elkay has been a family-owned and operated company,providing thousands of jobs that support our Template Included: Yes families and communities. Cutout Template#: 1000001179 Product Compliance: ASME Al 12.19.3/CSA B45.4 Template is available for download at elkay.com Clean and Care Manual(PDF) Cutout Dimensions for Top Mount Installation: Installation Instructions(PDF) 24-3/8"x 21-3/8"(619mm x 543mm)with 1/2"(12mm)corner radius Limited Lifetime Warranty(PDF) Hole Drilling Configurations: 1-1/2"(38mm)Diameter Faucet Holes on 4"(102mm)Centers 5" �O ® \ O O / (127mm) 22" F® O O O (559mm) 16-3/4" � O ® \ / \ / qq (425mm) © ( 0 0 (D (D (D (D (D (RSm1m) 22-1/2, ® O O O O O (571 mm) —�� 25" (635mm) it 9" L 6" (228mm) mm) — PART: CITY: PROJECT: CONTACT: DATE: NOTES: APPROVAL: In keeping with our policy of continuing product improvement, Elkay reserves the right to change product specifications without notice.Please visit elkay.com for the most current version of Elkay product specification sheets. This specification describes an Elkay product with design,quality,and functional benefits to the user. When making a comparison of other producers'offerings,be certain these features are not overlooked. Elkay REV 12152017 2222 Camden Court ©2017 Page 1 ECTSR25229BG Oak Brook, IL 60523 ECTSR25229BG_spec.pdf LU ELKAY Elkay Crosstown Stainless Steel 25" x 22" x 9" SPECIFICATIONS Single Bowl Dual Mount Sink Kit Model(s) ECTSR25229BG Installation Profile: Top Mount Silicone Caulkf U-Channel Countertop ~Sink I Clip Screw Undermount-1/8"Overhang Countertop— 1 Mounting Clipt_*1 % " _ Silicone Caulkr Fastener' Sink 'Not furnished (3mm) Designed to affix to the underside of any solid surface countertop. OPTIONAL ACCESSORIES Drain: JLK35, LKDS35, LK99S Hardware: ILKUCLIP8 Sinkmate: ILKSMHSL In keeping with our policy of continuing product improvement,Elkay reserves the right to change product specifications without notice.Please visit e/kay.com for the most current version of Elkay product specification sheets. This specification describes an Elkay product with design,quality, and functional benefits to the user When making a comparison of other producers'offerings.be certain these features are not overlooked. Elkay REV 12152017 2222 Camden Court ©2017 Page 2 ECTSR25229BG Oak Brook, IL 60523 ECTSR252298G_spec.pdf 11 Simplice® KOHLER, Faucets Pull-down kitchen sink faucet with three-function sprayhead K-596 Features • Three-function pull-down sprayhead with touch-control allows you to switch between stream, Sweep@ spray and Boost technology • Sweep@ spray creates a wide, forceful blade of water for superior cleaning ' Boost technology increases the flow rate by 30%with the press of a button • KOHLER@ ceramic disc valves exceed industry longevity standards for a lifetime of durable performance a" ' ProMotion@ technology's light, quiet braided hose and - swiveling ball joint make the pull-down sprayhead easier and - more comfortable to use ' MasterCleanTM sprayface features an easy-to-clean surface that withstands mineral buildup and maximizes spray ADA 16SA B6511 performance ' High-arch spout offers superior clearance for filling pots and Codes/Standards cleaning ASME A112.18.1/CSA 13125.1 • Single handle is simple to use and makes adjusting water NSF/ANSI/CAN 61 temperature easy NSF/ANSI/CAN 372 DOE- Energy Policy Act 1992 Temperature memory allows faucet to be turned on and off at California Energy Commission (CEC) the temperature set during prior usage ADA • 1.5 gpm (5.7 Ipm) maximum flow rate at 60 psi (4.14 bar) ICC/ANSI Al 17.1 • DockNetik@ secure docking system locks sprayhead into CSA B651 place when not in use Material KOHLER& Faucet Lifetime Limited ' Premium metal construction for durability and reliability Warranty ' KOHLER finishes resist corrosion and tarnishing See website for detailed warranty information. Installation Available Colors/Finishes • For single-hole or three-hole installation (escutcheon plate Color tiles intended for reference only. included) ' Flexible supply lines and installation ring simplify installation Color Code Description Recommended Products/Accessories CP Polished Chrome K-77685 Single-cartridge water filtration system VS Vibrant®Stainless K-77686 Double-cartridge water filtration system ® BL Matte Black K-77687 single replacement filter cartridge VibrantO Brushed Moderne K-77688 Replacement Filter Cartridges,Two-Pack 2MB Brass Optional Products/Accessories 1012715 Kitchen Faucet Deep Rough-In Kit 1-800-4KOHLER (1-800-456-4537) THE BOLD LOOK Kohler Co. reserves the right to make revisions without notice to product specifications. OF KOHLER For the most current Specification Sheet,go to www.kohler.com USA or w_ww.kohler.ca Canada 4-16-2025 20:50 - US/CA 12 Simplice® KOHLER. Faucets Pull-down kitchen sink faucet with three-function sprayhead K-596 3-15/16" 9" (229 mm)--{ 2-1/4" (100 mm) I (57 mm) 02, 16-5/8" �51 mm� I (422 mm) ' 9-5/81, 7 10-1/2" r� (244 mm) (267 mm) (159 mm) 1-5/16 0 _ _ 2-1/2" --- (64 mm) Max Escutcheon Width 0 2" (51 mm) for single hole C 2-1/2" (64 mm) for three hole 31-1/4" Supply Hoses (794 mm) with 3/8" Compression Fitting Technical Information Notes All product dimensions are nominal. Install this product according to the installation Faucet flow rates 1.5 gal/min (5.7 I/min) guide. ADA compliant for faucet handles only. Spout: ADA compliant for faucet handles only Spout reach: 9" (229 mm) ADA, CSA B651 compliant when installed to the specific requirements of these regulations. 1-800-4KOHLER (1-800-456-4537) THE BOLD LOOK Kohler Co. reserves the right to make revisions without notice to product specifications. OE KOHLER, For the most current Specification Sheet, go to www.kohler.com USA or www_kohler.ca Canada 4-16-2025 20:50 - US/CA 13 A —00 k1h t ho Commercial Electric In Water Heaters DURA-POWER TM Designed for use as a recovery heater having its own storage tank.Available in upright standard models(DEN)and lowboy models(DEL). GLASSLINED TANK CSA CERTIFIED AND ASME RATED • Thirteen sizes;6 thru 119 gallon T&P RELIEF VALVE capacity.Tank interior is coated with SIMPLIFIED CIRCUITRY,COLOR glass specialty designed by A.0.Smith CODED FOR EASE OF SERVICE for water heater use. ANODE ROD FOR MAXIMUM ELEMENTS CORROSION PROTECTION • Zinc plated copper sheaths for longer CABINET HAS BONDERIZED life.Medium watt density means lower UNDERCOAT WITH BAKED surface temperature to minimize scale ENAMEL FINISH build-up and more surface to heat water.Element sizes from 1.5 to 6.1 KW. TOP INLET AND OUTLET OPENINGS Maximum input KW(see chart). DRAIN VALVE STANDARD VOLTAGES (EXCLUDES DEL 6-20) • 120,277 single phase and 208,240 UL APPROVED FIELD CONVERSION and 480V unbalanced three-phase PROGRAM delta;easily converted to single-phase at COMPLIANCE terminal block with limited exceptions. Single element heaters,single-phase Meets the standby loss Requirements only. of the U.S.Department of Energy and TERMINAL BLOCK current edition of ASHRAE/IES 90.1 • Factory-installed.Just bring the service LIMITED WARRANTY OUTLINE - to heater and connect to block.Terminal • If the tank should leak any time during DEN-40 block not supplied on 120V&277 volt the first three years,under the terms of DEL-30 models.(No junction box on DE16-20) the warranty,A.0.Smith will furnish a CONTROLS replacement heater;installation,labor, handling and local delivery extra.THIS • Temperature control(adjustable OUTLINE IS NOT A WARRANTY.For c&s through a range of 110'to 170°F on complete information consult the written single element and 1200 to 181°F on warranty or A.0.Smith Water Products dual element)and manual reset high Company. temperature cutoff per element ®September 2022 A.0.Smith Corporation.All rights reserved. www,hotwater.com 1800-527.1953 Toll-Free USA I A.Q Smith Corporation 1500 Tennessee Waltz Parkway I Ashland City,TN 37015 nos cE 1 saoo 14 fA 'It h. Commercial Electric ro Water Heaters ANODES ANODE OUTLET INLET OU FILET INLET OUTLET INLET 3/4'(FEMALE) 3/4-(FFMAI.F.) WO(FEMALE) Q 314'(FFMAI E) 314(FE1.1ALE) J14'(FEMALE; NPT D— NPT NPT 0 NPT NPT .0.. NPT O 314'NPT RELIEF VALVE -'[ OPENING JUNCTION [.- 2112' JUNCTION t, JUNCTIONS TOPVFF.W y112' Box 163.E mm) Box (63.5 mm) Box DEN 6 120 el 5 mm) TOP VIEW TOP VIEW TOP VIEW DEL 30140150 UEN 30-62 UEL Fl10/1 S20 ALTERNATE OUTLET B- tl�► TLET 314'(FEMALE)NPT ouEMA 3/6'(FEMALE) NPT 3W NPT 3/4'NP7 H I RELIEF VALVE RELIEF VALVE 3/4'NPT • 'A' OPENING OPENINGH RELIEF VALVE DRAIN OPENING VALVE C A G A B C A ELECTRICAL O < CONNECTION I I 3 W(951f mm) VALVEDRAIN DRAIN INLET -I]3Ii-IIIil FRONT VIEW VALVE O VALVE O 316'(FEMALE) DEN 66120 ---- NPT FRONT VIEW FRONT VIE:N FRONT VIEW DEL 301401so LIEN 30.12 DEL 6/1 011 5 2 0 '(NO SIDE OUTLET AVAILABLE FOR DEL-6 MODELS) ROUGH-IN DIMENSIONS No.of Nominal Rated A B C D Shipping Weight Models UEF Elements Capacity Storage Volume Inches mm Inches mm Inches mm Inches mm lbs. Kg. DEL-6 NIA 1 6 6 15-112 394 14-114 362 11 279 N/A NIA 35 15.9 DEL-10 IV1A 1 10 10 18-114 464 18 457 12-112 319 NA NIA 54 24.5 DEL-15 N/A 1 15 15 26 660 18 457 20-112 S21 N1A N/A 58 26.3 DEL-20 N/A 1 20 19 22 1/4 565 21-3/4 552 15-3/8 391 N/A N/A 73 33.1 DEL-30 0.92 2 36 33 32 813 24 610 24 F,10 8 203 118 53.5 DEL-40** 0.92 2 38 35 32 813 23 584 24 610 8 203 118 1 53.5 DEL-50 0.92 2 51 48 136 914 26-1/2 673 25 635 8 203 172 1 78 DEN-30 0.92 2 40 37 49-3/4 1 1264 20-1/2 1 521 53-1/4 1353 8 203 118 53.5 DEN-40 0.92 2 50 46 59 1499 20-1/2 521 51-1/4 1302 8 203 125 56.7 DEN-52 0.92 2 55 55 56-1/2 1435 24 610 48-1/2 1232 8 203 145 65.8 DEN-66 N/A 2 66 60 60-3/4 1543 21-3/4 552 N/A N/A 8 203 176 79.8 DEN-80 N/A 2 80 76 59-3/8 1508 24 610 NIA N/A 8 203 1 211 1 95.7 DEN-120 N/A 2 120 108 62-7116 1586 29-3/8 746 NIA N/A 8 203 326 147.9 U.S Gallons/HR and Litres/HR at Temperature Rise Indicated Element rn tit F° 36 F° 40 F° 54 F° 60 F° 72 F° 80 F° 90 F° 100 F° 108 F° 120 F° 126 F° Wattage P (Upperltower) KW C" 20 C° 22.2 C° 30 C° 33.3 C° 40 C' 44.4 C° 50 C" 55.5 C° 60 C° 66.6 C° 70 C° GPFI 138 124 92 82 69 62 55 49 46 41 39 610016100'• 12.2 LPH 522 469 348 310 261 235 208 184 174 153 146 'No side outlet available on DEL-6 Model "Blanketrnodel Note-All 66,80,120 models can only he ordered?I IV,240V,or 480V Page 2 of 4 AOSCE15400 15 CAL Commercial Electric is m 'It he Water Heaters ELEMENT AVAILABILITY CHART (LIGHT-DUTY COMMERCIAL ELECTRIC) Models&Elements Voltage Wiring kW Input Available 120V 1.5 2 2.5 3 208V L5 7 2.5 3 6-Gallon Models 240V L5 2 2.5 3 Single-Element 277V 1.5 2 2.5 3 480V 2 J`, 3 120V 1.5 2 2.5 3 10-Gallon through 208V 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 20-Gallon Models 240V 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 Single-Element 277V 1.5 2 2.5 1 3 4 4.5 5 6 480V 2 2.5 3 4 4.5 5 5.5 6 6 gallon model not available above AW 6/10/15120 gallon models all A6 circuit(2 wire)only Model Element Wattage 120V 208V 240V 277V 480V Min Watts N/A 4500 4500 4500 4500 DEL-30 Max Watts N/A 6000(') 6000(*) 6000 6000 Min Watts N/A 4500 4500 4500 4500 DEL-40 Max Watts N/A 6000(*) 6000(*) 6000 6000 Min Watts N/A 4000 4000 4000 4000 DEL 50 Max Watts N/A 6000(') 6000(') 6000 6000 Min Watts N/A 4500 4500 4500 4500 DEN-30 Max Watts N/A 6000(*) 6000(*) 6000 6000 Min Watts 3000(') 3000 3000 3000 3000 DEN-40 Max Watts 3000(*) G000(*) 6000(*) 1 6000 6000 Min Watts 2500 2500 2500 2500 2500 DEN-52 Max Watts 3000(') 6000(') 6000(') 6000 6000 Additional limitations apply to 120V,208V and 240V-Simultaneous Operation are not available(')for these voltages. 3 phase only on 240 6000 watt for simultaneous operation Page 3 of 4 AOSCE15400 16 Commercial Electric t ho Water Heaters RECOVERY CAPACITIES Element U.S.Gallons/Hr and Litres/Hr at Temperature Rise Indicated Wattage Input (Upped F° 1 36 1 40 54 60 72 80 90 100 108 120 126 Lower) kW C. 20 22.2 30 1 33.3 1 40 44.4 50 55.5 60 66.6 70 Non-Simulataneous Operation 11500 15 GPH 17 15 11 10 8 8 7 6 6 5 5 LPH 64 58 43 38 32 29 26 23 21 19 18 l2000 2 GPH 23 20 15 14 11 10 9 8 8 7 6 LPH 85 71 57 51 43 38 34 31 28 26 24 I2500 2.5 GPH 28 25 19 17 14 13 11 10 9 8 8 LPH 107 96 71 64 53 48 43 38 36 32 30 3000/3000 3 GPH 34 30 23 20 17 15 14 12 11 10 10 LPH 128 115 85 77 64 58 51 46 43 38 37 GPH 45 41 30 27 23 20 18 16 15 14 13 400014000 4 LPH 170 153 114 102 85 77 68 61 57 51 49 4500/4500 4.5 GPH 51 46 34 30 25 23 20 18 17 15 14 LPH 1 192 173 1 128 115 96 86 7/ 69 64 58 55 GPH 56 51 38 34 28 25 23 20 19 1 17 16 5000/5000 5 LPH 213 192 142 128 107 96 85 77 71 64 61 600016000 GPH 68 61 45 41 34 30 27 24 23 20 19 LPH 256 230 170 153 128 115 102 92 85 77 73 Simulataneous Operation 300013000 6 GPH 68 61 45 41 34 30 27 24 23 20 19 LPH 256 230 170 153 128 115 102 92 85 77 73 400014000 8 GPH 90 81 60 54 45 41 36 32 30 27 26 LPH 341 307 227 205 170 153 136 123 114 102 97 450014500 9 GPH 101 91 68 61 51 46 41 36 1 34 30 29 LPH 384 345 256 230 192 173 153 138 128 115 1 110 GPH 113 101 75 68 56 51 45 41 38 34 32 [PH 5000/5000 10 i26 384 284 256 213 192 170 153 142 128 122 600016000 2 GPH 135 122 90 81 68 61 54 49 45 41 39 LPH 511 460 341 307 256 230 205 1 184 170 153 146 Recovery capacities at 100°F rise equal for non-simultaneous element operation=4.1 gal.x kW of one element;for simultaneous element operation=4.1 gal.x 213 kW of both elements. For other rises multiply element kW as previously explained by 410 and divide by temperature rise.Full load current for single phase=total wattslvoltage. SPECIFICATION The water heaters(s)shall be Dura-Power"Model(s)No. Q as manufactured by A.0.Smith or an approved equal. Heater(s)shall be rated at—3—kW, avolts, l -phase,60 cycle AC,and listed by Underwriters' Laboratories.Models shall meet the standby loss requirements of the U.S.Department of energy and current edition of ASHRAEIIES 90.1.Tank(s)shall be 11gallon capacity.Heater(s)shall have 150 psi working pressure and be equipped with extruded high density anode rod.All internal surfaces of the heaters)exposed to water shall be gla»lined with an alkaline borosilicate composition that has been fused-to-steel by firing at a temperature range of 1400°F to 1600°F.Electric heating elements shall be medium watt density with zinc plated copper sheath.Each element shall be controlled by an Individually mounted thermostat and high temperature cutoff switch.The outer jacket shall be of backed enamel finish and shall enclose the tank with foam insulation.Electrical junction box with heavy duty terminal block shall be provided(except on 120V&277V(no junction box on DEL-6 thru 20)).The drain valve shall be located in the front for ease of servicing.Heater tank shall have a three year limited warranty as outlined in the written warranty.Fully illustrated instruction manual to be included. for technical information,�,ill rr 0.Smith Corporation reserves the right to make product changes or improvements without prior notice. Z)September 2022 A.0.Smith Corporation.All tights reserved. Page 4 of 4 www.hotwater.com 1 800-527-1953 Toll-Free USA I A.0.Smith Corporation 1 500 Tennessee Walt2 Parkway I Ashland City,TN 37015 AOSCE15400 17 m 'i' thCommercial Electric ® Water Heaters DURA-POWER TM Designed for use as a recovery heater having its own storage tank.Available in upright standard models(DEN)and lowboy models(DEL). GLASSLINED TANK CSA CERTIFIED AND ASME RATED • Thirteen sizes;6 thru 119 gallon T&P RELIEF VALVE capacity.Tank interior is coated with SIMPLIFIED CIRCUITRY,COLOR glass specially designed by A.0.Smith CODED FOR EASE OF SERVICE for water heater use. ANODE ROD FOR MAXIMUM ELEMENTS CORROSION PROTECTION • Zinc plated copper sheaths for longer CABINET HAS BONDERIZED life.Medium watt density means lower UNDERCOAT WITH BAKED smgA surface temperature to minimize scale ENAMEL FINISH build-up and more surface to heat water.Element sizes from 1.5 to 6 KW. TOP INLET AND OUTLET OPENINGS Maximum input 12 KW(see chart). DRAIN VALVE STANDARD VOLTAGES (EXCLUDES DEL 6-20) • 120,277 single phase and 208,240 UL APPROVED FIELD CONVERSION and 480V unbalanced three-phase PROGRAM delta;easily converted to single-phase at COMPLIANCE terminal block(except 208V with 5500 watt elements).Single element heaters, Meets the standby loss Requirements single-phase only. of the U.S.Department of Energy and TERMINAL BLOCK current edition of ASHRAE/IES 90.1. • Factory-installed.Just bring the service LIMITED WARRANTY OUTLINE to heater and connect to block.Terminal • If the tank should leak any time during DEN-40 block not supplied on 120V&277 volt the first three years,under the terms of models.(No junction box on DEL6-20) the warranty,A.0.Smith will furnish a DEL-30 CONTROLS replacement heater;installation,labor, handling and local delivery extra.THIS • Temperature control(adjustable OUTLINE IS NOT A WARRANTY.For CIP W c&us through a range of 130°to 170°F on complete information consult the written single element and 120'to 181°F on warranty or A,0.Smith Water Products dual element)and manual reset high Company. temperature cutoff per element CERTIFIED- 0 March 2019 A.0.Smith corporation.All rights reserved. www.hotwatereom 1800-527-1953 Toll-Free USA I A.a Smith Corporation 1 500 Tennessee Walt:Parkway i Ashland City,TN 37015 AOSCE t 5400 18 eAL t hCommercial Electric le M1 ® Water Heaters ANODES ANODE OUTLET INLET OUTLET INLET UU1LE1 INLET 14'(FEMALE) 314-(FEMALE) 3f4'(FEMALF.) 31e(FEMA'r) 314'(FEMALE) 014'(FEEMALE) NPT p NPT NET p NPT NPT -p- NPT O 0 14'NPT RELIEF VALVE 1 OPENING JUNCTION -�2Imm) JUNCTION `2112' JUNCTION TOPVIEW t,2112' Box (63.5 BOX (63.5 mm1 BOX DEN6S120 TOP VIEW TOP VIEW TOP VIEW Da 36140150 DEN 30-52 DEL sn1115120 .B- ALTERNATE OUTLET P 6 - 314'(FEMALE)NET OUTLET 14'IFEMALE) ` NPT 314'NPT 14 NPT NELIEF VALVE I LIEF VALVE 314'NPT • -A' OPENING OPENING RELIFF VAINF pRA1N OPENING VALVE C A C A R C A ELECTRICAL o CONNECTION 3 3f4'(9525 mm) DRAIN DRAIN INLET VALVE 0 VALVE 0 31!'(FEMA DEENN66-120LE) FRONT NPT 6120 '40,`J t VIEV.' FRONT VIEW FRONT VIEW DEL 3DMO,00 OEN 30.52 DEL 6110115120 '(NO SIDE OUTLET AVAILABLE FOR DEL-6 MODELS) ROUGH-IN DIMENSIONS No.of Nominal Rated A B C D Shipping Weight Models LIEF ElementsCapacity Storage Volume Inches mm Inches mm Inches mm Inches mm Ibs. Kg. DEL-6 N/A 1 6 6 15-1/2 394 14-1/4 362 11 279 N/A N/A 35 15.9 DEL-10 NIA 1 10 10 18-1/4 464 18 457 12-112 318 NIA NIA 54 24.5 DEL-15 N/A 1 15 15 26 660 18 451 20-112 521 N/A N/A 58 26.3 DEL-20 N/A 1 20 19 22-1/4 565 21-3/4 552 15-3/8 391 N/A NIA 73 33.1 DEL-30 0.92 2 36 33 32 813 24 610 24 610 8 203 116 53.5 DEL-40** 0.92 2 38 35 32 813 23 584 24 610 8 203 118 53.5 DEL-50 0.92 2 51 48 36 1 914 26-1/2 673 25 635 8 203 172 78 DEN-30 0.92 2 40 37 49-3/4 1 1264 20-1/2 521 53-1/4 1353 8 203 118 1 53.5 DEN-40 0.92 2 50 46 59 1499 20-1/2 521 51-1/4 1 1302 8 203 125 56.7 DEN-52 0.92 2 55 55 56-1/2 1435 24 610 48-1/2 1232 8 203 145 65.8 DEN-66 N/A 2 66 60 60-3/4 1543 21 3/4 552 N/A N/A 8 203 176 79.8 DEN-80 N/A 1 80 76 59-3/8 1508 24 610 N/A NIA 8 203 211 95.7 DEN-120 NIA 2 120 108 1 62-7116 1 1586 1 29-3/8 1 746 N/A N/A 8 203 326 147.9 U.S Gallons/HR and Litres/HR at Temperature Rise Indicated Element Inpwt F' 36 F' 40 F° 54 F' 60 F' 72 F' 80 F' 90 F' 100 F° 108 F' 120 F° 126 F' Wottoyc (Upper/Lower) C. 20 C' 22.2 C° 30 C' 33.3 C' 40 C° 44.4 Co 50 C' 55.5 C' 60 C' 66.6 C° 70 C' GPH 138 124 92 82 69 62 55 49 46 41 39 61 0 0161 00'• 12.2 LPH 522 469 348 310 261 235 208 184 174 153 146 'No side outlet available on DEL-6 Model "Blanket model Note.All 66,80,120 models can only be ordered 2 M,,240V,or 480V Page 2 of 4 AOSCE15400 19 ' thoI m Commercial Electric Water Heaters ELEMENT AVAILABILITY CHART (LIGHT-DUTY COMMERCIAL ELECTRIC) Models&Elements Voltage Wiring kW Input Available 120V 1.5 2 2.5 3 208V 1.5 2 2.5 3 6-Gallon Models 240V 1.5 2 2.5 3 Single-Element 277V 1.5 2 2.5 3 480V 2 2.5 1 3 120V 1.5 2 2.5 3 10-Gallon through 208V 1.5 2 2.5 3 3. 4 4.5 5 5 6 20-Gallon Models 240V 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 Single-Element 277V 1.5 2 2.5 3 4 4.5 5 6 480V 2 2.5 3 1 4 4.5 5 5.5 6 6 gallon model not available above 3kW 611 0/1 5120 gallon models all A6 circuit(2 wire)only Model Element Wattage 120V 208V 240V 277V 480V Min Watts N/A 4500 4500 4500 4500 DEL-30 Max Watts N/A 6000(*) 6000(*) 6000 6000 Min Watts N/A 4500 4500 4500 4500 DEL-40 Max Watts N/A 6000(*) 6000(*) 6000 6000 Min Watts N/A 4000 4000 4000 4000 DEL-50 Max Watts NIA 6000(*) 6000(-) 6000 6000 Min Watts N/A 4500 4500 4500 4500 DEN 30 Max Watts N/A 6000(') 6000(') 6000 6000 Min Watts 3000(') 3000 3000 3000 3000 DEN 40 Max Watts 3000(') 6000(*) 6000(*) 6000 6000 Min Watts 2500 2500 2500 2500 2500 DEN-52 Max Watts 3000(') 6000(*) 1 6000(') 6000 6000 Additional limitations apply to 120V,208V,and 240V-Simultaneous Operation are not available(*)for these voltages. 3 phase only on 240 6000 watt for simultaneous operation Page 3 of 4 AOSCE15400 SUMP PUMPS Little G M T MENU WRS SERIES -1/6 HP,1/3 HP,4/10 HP DRAINOSAUR"&DRAINOSAUR JR."' APPLICATIONS , r Impractical drainage areas,under sinks,laundry trays FEATURES } BASIN FEATURES ■ 3.5 and 5 gallon size options WRS 5 ■ Polypropylene,lightweight,corrosion-resistant ■ Designed with 0-rings for watertight seal WRS-6 ■ Cover includes removable filter for easy cleaning ... ■ Cover includes 2"FNPT discharge(outlet),2"FNPT vent,1-1/2" FNPT inlet,and 2"MNPT to 1-1/2"FNPT reducer bushing ■ IAPM0listed ■ Pre-assembled,ready to install PUMP FEATURES WRS(-6 ■ 1/6,1/3,and 4/10 hp options ■ Multiple switch options ■ c(SAus listed(pump only) WRS-9 SPECIFICATIONSSERIES 1/6 n5 60 5 380 15(57) 12(45) 8(30) - 21'(6A m) 9.1 V3 115 60 9 720 1 46074) 29 010) 13(49) 1 - 18'(SA9 m) 7.8 4/10 115 60 7.5 800 10(265) 65(246) 55(208) 50(189) 40'02.19 m) 17.3 505055 WRS-5 V6 IS 5Gallon PlggYhackDianhragm 6"-9" 1"-4' 10,Orn) 19 505300 5-ASP (151cm-23 cm) 2Scm•10-) 24 506065 WRSC-6 1/3 115 3.5 Gallon Integral DiaDlua9m (10.2 Cm-17.8 Cm) (15 cm.7.6 cm) 10'( ) n0.89 Kg) 506160 6•CIA•t4l 506055 WRS-6 1/3 n5 5 Gallon Integral Diaphragm M.8 cm-2S 4 cm) (2S cm-101 cm) to y n1.79 Kg) 506158 6 CIA $09268 WRS-9 4710 115 5 wagon Plggyoack vernal necnanttei (17.8 cm-25A cm) (5 Cm 117 cm) 10�"1 05.88 Kg) soveos oec•ciM SSPMJ�► 28 24 SUMP PUMPS WRS SERIES-1/6 HP,1/3 HP,4/10 HP PERFORMANCE DATA WRS-5 WRS-6 & W 9 6 Flow/Capacity in Liters Per Minute Flow/Capacity in Liters Per Minute 0 10 20 30 40 50 0 30 60 90 120 150 180 25 25 i2 20 6 a; 20 _...._.__. -- 6 a 15 a 15 — -- y 4 x 4 z V V_ p 2 0 2 5 T 5 0 0 5 10 15 20 0 0 0 10 20 30 40 50 0 Flow/Capacity in US Gallons Per Minute Flow/Capacity in US Gallons Per Minute WRS-9 45 40 35 30 Cm 15 x 20-- 15-- 10 5 0 0 10 20 30 40 50 60 70 80 Flow/Capacity in US Gallons Per Minute ®Franklin Elmotrio TKWWSWpoR1lD0.10V694 I wwwJt"mt.com 25 OnSite PRO Inc. F �ITLetp-W Stop Flood Damage Before It Really Startsi. FloodStop FS3/4NPT is a point of use, leak detection and automatic water shut-off system designed for residential and commercial dwellings. The FS3/4NPT uses a Motorized Ball Valve to automatically shut off the water supply whenever your water heater leaks! G.A. Murdock, Inc. Phone 605.256.9632 1200 S Division Ave Fax 605.256.9682 L Madison,SD 57042 www.garnurdock.com - � Water Heaters FS3/4NPT 31V 01M i ©fir Install in Minutes! ` Kit includes everything you need to protect your property: r $ • 3/4"Motorized Ball Valve installed on cold water inlet. ` • Water sensor is placed on the floor. • Control Unit is mounted with screws or Velcro(included). �`■�+�� • Optional Power Sources:AC&(4)AA Batteries,or Batteries alone! Off Technical Specifications: • UL listed class 2 wall adaptor,115AC/9VDC • UPC listed Full-Port Motorized Ball Valve.CNC machined. FloodStop Product Lineup: • Motor operates at 6VDC. F53/4H-90 Washing Machine(Hose Fittings) • Signal Output:1 Normally Open,24 Volt/2 amp rated FS3/4H Washing Machine(Hose Fittings) • Motorized Ball Valve:CNC machined with MIP X FIP. FS3/4NPT Water Heater 3/4"(MIP X FIP) • Rated 0-180 PSI.Max 250 PSI.Solid brass.AB1953, UPC,CUPC,NSF61 cert. FS3/4C Water Heater(3/4"Compression) • Rated 32-212 degrees F FS10ONPT Water Heater(1.00" (MIP X FIP) • Sensor:1.25 X 7.5 inch,double sided.Additional sensors may be added In FS125NPT Water Heater(1.2S" (MIP X FIP) series. FS1/2NPT Water Heater 1/2" (MIP X FIP) • Alarm:Beeping with Mute button. FS3/8C Dishwasher,Toilet(3/8"Compression) FS3/8CD Sink(3/8' Compression) FS1/4C Ice Maker(1/4"Compression) 26 THERM=X=TROL. Thermal Expansion Tanks: ST Series Non-ASME AMTROL 150 PSIG Working Pressure Construction Application Shell Steel • For use in closed, potable hot water systems to Diaphragm Heavy Duty Butyl NSF/ANSI 61 control pressure buildup. Liner Antimicrobial Polypropylene •Accepts expanded water as temperature rises to System Connection Stainless Steel prevent relief valve discharge and system damage. Finish Urethane Topcoat • Stand models designed for large residential and Water Circulator Turbulator® light commercial applications. Air Valve Projection Welded with InSight" • Multiple units can be installed to accommodate Indicator Cap(In-Line Models Only) larger systems. Factory Precharge In-line Models 50 PSIG(3.5 bar) • In-line models feature paten-pending InSight® Stand Models 40 PSIG(2.8 bar) Indicator Cap that changes color to indicate tank Performance service. Maximum Operating Temperature 200oF(93oC) Maximum Working Pressure 150 PSIG(10.3 bar) Warranty ST-5 through ST-12:7-Year Limited ST-25V through ST-210V: 1-Year Limited In-Line Models l.' A—*i SYSTEM- System CONNECTION Tank Max. A a Connection Shipping Model Volume Acceptance Tank Diameter Tank Height (NPTM) Weight Number Factor Gal Lit In mm In mm In Lb Kg B ST-5 2.0 8 .45 8 203 13 330 % 5 2.3 ST-12 4.4 1 17 .73 11 279 15 381 '/, 9 4.1 CHARGING VALVF� Stand Models m Tank A B MaxCoSystennection Shipping Model Volume Acceptance Tank Diameter tank Height (NPTF) Weight 14 A CHARGING Number Factor VALVE Gal Lit In Tim In Tim In Lbs Kg ST-25V 10.3 39 1.00 15 381 19 483 % 23 10 ST-30V 14.0 53 0.81 15 381 24 610 '/, 25 11 ST-42V 20.0 76 1 0.57 15 381 32 813 '/. 33 15 e ST-60V 34.0 129 1.00 22 .559 30 762 1'/. 61 28 ST-80V 44.0 167 0.77 22 559 36 914 1''/< 69 31 ST-180V 62.0 235 0.55 22 559 47 1194 1'/. 92 42 ST-200V 81.0 307 0.44 22 559 56 1422 1'/. 103 47 sysTEN, 1 CONNECTION ST-210V 86.0 326 0.54 26 660 47 1194 1'/. 123 56 All dimensions and weights are approximate A InSight. Antimicrobial. Job Name _---- ---- -- Notes ..._. Engineer ----- — - — PI Q`. Turbulator LEAD FREE Contractor ® UPC P.O.No. -- _ _ c " --�_--- ( MODELS ST-5 THROUGH ST-AV Sales Rep, _- ____.... LEAD FRU FAR Model No, -- —._-- -._ A `' 34 Amtrol Inc.,1400 Division Road,West Warwick,RI 02893 USA T.401.884.6300 www.amtrol.com MG4400(0T24) 27 LACAVA LINEA LIN-UN-60B 60 0 4 __ - 5 N (CV M M � I � I I i Recommended installation height FEATURES: FINISHES: •Recommended plumbing location WALL MOUNT VANITY WOOD: FOUR DRAWERS WITH SELF-CLOSE GLIDES STANDARD: PREMIUM: LUXURY: 6-DRIFTWOOD 02 NATURAL CHERRY 22 GRAY ZEBRA 37-WEATHERED OAK NEWTERRA ONLY DRAWER BOXES STAINED TO REFLECT EXTERIOR FINISH 07-NATURAL WALNUT 31-WHITE OAK 52-SILVER OAK 24-CLASSIC WALNUT 27-RUSTIC 50-HORIZON BLUE MITERED DETAILING ON DRAWERS 20-ASH GRAY 47-SMOKY WALNUT 06-WENGE METALS: LIN-UN-60BF DECORATIVE HARDWARE K450INCLUDED BUT 33-AFRICAN 08 MATTE WHITE 85-GLOSS WHITE NOT INSTALLED-CAN BE INSTALLED UPON REQUEST MAHOGANY 35 MATTE ARDESIA 88-GLOSS ARDESIA METAL: FRAME 54 MATTE TAUPE 84 GLOSS TAUPE 21-BRUSHED STAINLESS STEEL USED WITH LIN-UN-608F FRAME,LIN-UN-60BT 16 MATTE BLACK 86 GLOSS BLACK 10 POLISHED STAINLESS STEEL 42-MATTE OLIVE GRFFN 82 GLOSS OLIVE GREEN COUNTERTOP AND 5446UN SINK(SOLD SEPARATELY( 39-MATTE SAGE 44 MATTE BLACK 28 MATTE AZURE MW MATTE WHITE MOUNTING:FULL WOOD BACKING 29 MATTE CLOUD BPW BRASS POWDER COAT 40 MATTE ZEST SA.SIENNA (SEE FURNITURE MANUAL( -PROUDLY HANDMADE IN THE USA COUNTERTOP: LIN-UN-60BT MANUFACTURED WITH LOW VOC FINISHES TONE: UARTZ: SOLID SURFACE: ONCRETE: AND WOOD FROM RENEWABLE FORESTS H-BIANC R-PURO M-SATIN WHITE ND-SAND BRK-BRICK N I INAC H ASH G-POI ISHFD WHITE 'I.T-SLATE MAH-MATCHA N-AT T CR@T R-MAkMO UN-SUN GAL-GALAXY N-VENA V-LAVA LY-CLAY TER-TLRRACOTT N DUNr D-OBSIDIAN 11.-LILAC CHL-CHARCOAL R NE O C-CREMA vtOS-MOSS BST-BASAL TO A,QA-AGUA LACAVA w9orv®s tho nahl In revKe onv dbnanslon nr Infn rnntlnn r+n R*sheet WithOLIt nolice. Dimensions ore nomfnd and may vat Y rilhin or industry occoptad folei once of I/4', Cobinots wilh'vanity top slnits are mods to tho motching sink and dlrnonslons may vary LACAVA Is nn1 resnonslole for any cutouts.countertops or lumlluul made Without Iho actual product of lomplole D3fererces In color groin oppoaronce and lexlvie are inheronl in al'nolurol woodwork and should be expoclad Vorianr-es it Those rlunl'ttes nre not rlenmen manvtuc W+Iny defecls and\All not bo accooted os valid masons Inr Mivm or oxchongc:. Pkinihing spscificntions nre only n 9vidollne antl may nncd olterotlun based on applicotlon 6630 WEST WRIGHTWOOD PH: 773-637-9600 LACAVA.COM CHICAGO,IL 60707 FAX:773-637-9601 INFOsLACAVA.COM t Y Li N �° w ►n N o way ■ L R O W eq L CL a ccn CA W `7 4-4 L; a h u C R rTr 31 Rc 00 ro- fir.+ L ZLn00 l 4 = � CA w o W U / � •� a � � � 0-4 V C 00 ' J �4 �ir BUILDING DEPARTMENT �u i AUG 2 2 2025 D. VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK, 1\Y 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT wwN.rN ebrooknV.Qor APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING VENTILATION AND/OR Am CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT #: / /Ip�✓ Approval Date: SEP 0 2 2025 Permit Fee: S Approval Signature: Other: Disapproved: (fees are non-refundable) *rt*rt*****************##**###**####**###*# *****************###*#######**############*t######**Ile*###**** DO NO"I 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 i REQUIREMENTS FOR RELEASE OF PERMIT& CERTIFICATE OF COMPLIANCE: I I. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. j 3. Copy of Contractor's Westchester County Home Improvement License,Liability Insurance. (Village of Rye Br(x)k must } be listed as certificate holder)& Workers Compensation Insurance on a NYS Board form tI orn,a CIn5.2 or Fom,a U26.3/or Nl' Slate Workers Compensation Waiver) i 4. Payment of Fees/Unit: RFSIDFNTIAI S200.004mil • COMMERCIAL S450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice reyuirecb 7. Electrical work requires a separate Electrical Permit & Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit & Plumbing Inspection. Application dated. 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: 3 kiLIDAMA bKm SBL: tltll�la-I-I Zone:) 2. Property Owner: i Address: _ Phone#: 14 I{-�133Cell#: email: 3. Contractor: _�p �� Address: SOK S%A� &4(&-% Phone#: Cell tt: email: rt�t�LO�n>t �e 4. Scope of Work: New Installation(W• Replacement 1 )• Removal( )•Other 5. List Equipment: AANL tiwlPA �&%d�e;akA AC%A rr y"~Qu..E(J #%a k%ck1Kt<. CV%O!C Boa, In-A&A\ ocw &cktjoe, samesxcS, a; cS aA t1x,%,c.ls. 6. Location of Equipment: 2M �% p( ---_- ----- 7. Method of Installalion'Removal(list all equipment needed to perlormjoh): t,,tu, AsxN-LA A* VXA oe *. a,ch,) SoGDa* 14 c. c�►eck ..+i{Ir. � rr�L}r� skims o< utn:s'�wt t 7:1,2025 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 46seal'. VLV-� ,being duly sworn,deposes and states(hat he/she is the applicant above named, (print name f 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 Sworn to before me this 7-7— day of a ,20 _ day of A/60;-� 20Z`� _ l m4 le- Tti� Signature of Property Owner�_ S n cure of Applicant J 1. t S Absecl^ Print ame of Pr,,opertydoviner Print Na the of Applicant Notary Pwlic Notary Pu �lAltllll��// TANYUI BUMW \\��OQN E R . tGOW. PUBIC STATE OF NEW YORK ......... A R ESTCHESTER COUNTY =2;N0.01 CU6367294 (�,, �lls 14 _(.): QUALIFIED IN .O M ��G _ :DUTCHESS COUNTY: _ COMM. EXP. — r. 11.13-2025 ; P U 6 L 1 r . �Q � This application must be properly completed in its entirety and must incltif3t♦,�1RAwt signature(s)of i the legal owner(s)of the subject property, and the applicant of record in the sl')Ny �rovided. Any 1 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. t GFk t R j A I { 2 Ntno25 a. ri c` N a o o m N C-4 fN w a f x x w n O � U a a ci 0.0 0-4 � � � �/I � \ � O J: ,<•1 " O � �: � 7 i. FBI C7 t.4 oc rr a F x 5 � v O w Y M a O c w ° W., ; 0 E � P. id CA W wallow � WC, oz O N F.•., � o ��C.. Gq Z p z S c a� 0 M z z oA ` BUILDI ( I3E;PARTMENT �— VIL�,A-'CsE OF RYE'O'ROOK AUG 19 2925 �--� 938 KING EET RYE BROO,NY 10573 a 4) y_066Y� VILLAGE OF RYE BROOK BUILDING DEPARTMENT` APPLICATION TO INSTALL FIRE SUPPRESSION / FIRE SPRINKLER SYSTEM FOR OFFICE USE ONLY: /� 7 Approval hate: 8-19- 7- liPa: S��7 -,-IPi": J Application Fee:$ Approval Signature: �.a • Permit Fees:$� Disapproved: Other: Application dated: 08/11/2025 is hereby made to the Building Inspector of the Village o f Rye Brook NY for the issuance of a Permit to install or modify a Fire Suppression/Fire Sprinkler System as per detailed statement described below. 1. Job Address: 1100 King Street(3 Intemational Drive) Rye Brook, NY 2nd Floor 2. Parcell.D.: 124.81-1-1 Zone: 3. Proposed Work(Describe system in detail including suppression agent): Relocation of sprinkler heads. 4. Number&Types of Fire Sprinkler Heads. 97 He 8 d S 5. N.Y State Construction Classification: Business Group N.Y.State Use Classification: 6. Estimated Value of Job:$ 18,000.00 i Value shall include all labor.materials. fixed equipment,processional tees.and materials and labor which may he donated gratis.) 7. Property Owner: 1100 King Associates, LLC Address: Phone# 914-934-1338 Cell# email: 8. Architect/Engineer: Russell Palu a;i Address: Phone# Cell# email: rpalucci308@gmaii.com 9. Sprinkler Contractor: Michael Uszakiewicz Address: 117 Great Hill Road, Naugatuck CT 06770 Phone#475-269-3473 Cell# 860-933-0465 email: me@blackwatersevieesgroup.com 6/trzo2n 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. li-4QW "A,C;;N STATE OF4#&*`fOW,COUNTY OF WE 9 NESTER ) 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 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 belicf,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 fore me this Swortt to fore me this If lo day of G�1 , 200 day of ,20 Ire WWF4Mperty 4OVr _&' Signature icant W•S i1G& CT6Mf Au) 6<'� !f>m` Print Name of Property O er P t me o Applicant Aa Notary Publ' N tary Public f 1AN'fV► NEW YORK it 30. �jWEBTATF ��l�1 OCAUNTY X.lYO � 14, Deb Dibner .E� Wiry Public,State of Connecticut l�J��" My Commission Expires 0413N2029 i 12024 Contractor's Material and = 'A Test Certificate for Fire Sprinkler SERVICES GROUP LLC FIRE PROTECTION Systems 117 Great Hill Road Naugatuck, CT 06770 This form is to be completed and given to the AHJ,during the final sprinkler inspection. The Forward Test of the Backflow and the Acceptance Testing of the Sprinkler System(See p.2 of this form&the attached memo),will also be performed during the finalsprinkler inspection. Project Name Quintessential Mortgage Group Date 10/28/25 Project Address 3 INTERNATIONAL DRIVE RYE BROOK,NY City Stamford State CT Zip 06901 AHJ Installation conforms to accepted plans X Yes ❑ No PLANS Equipment used is approved? X Yes ❑ No If no,explain deviations Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this new equipment? X Yes ❑ No If no,explain INSTRUCTIONS Have copies of the following been left on the premises? 1. Record Drawings&System Components Instructions X Yes ❑ No 2. Care&Maintenance Instructions X Yes ❑ No 3. NFPA 25 N/A ❑ Yes ❑ No Maximum time to operate Alarm device Through test connection ALARM VALVE Type Make Model Minutes Seconds or TENANT WORK FLOW ONLY. INDICATOR N/A Year of Orifice Temp. Make Model Manf. Size Quantity rating Victaulic V5606 2025 .5" 53 200 Victaulic V2704 2025 .5" 44 200 SPRINKLERS Dry valve QOD Make Model Serial# Make Model Serial# DRY PIPE Time to trip Time water Alarm OPERATING through test Water Air Trip point reached test operated TEST connection a,b ressure pressure Air pressure outlet a,bpro rl Seconds psi psi psi Seconds Yes No Without QOD N/A With QOD a Measured from time inspector's test connection is opened b NFPA 13 only requires the 60 second limitation in specific sections Page I of 2 Operation Pneumatic Electric Hydraulic Does valve operate from the manual trip,remote,or both stations Yes No Is there an accessible facility in each circuit for testing Yes No DELUGE If no,explain PREACTION Make F Model VALVES Detection media Piping Does each circuit operate Does each circuit Maximum time to supervised supervised supervision loss alarm operate valve operate release N/A release Yes No Yes No Yes No Yes No Seconds All piping hydrostatically tested at 200 psi for 2 hrs If no,state reason Dry pipe pneumatically tested,per NFPA 13 Yes X No Equipment operates properly X Yes No Do you certify as the sprinkler contractor that additives and corrosive chemicals,sodium silicate or derivatives of sodium silicate,brine,or other corrosive chemicals were not used for testing systems or sto in y leaks XYes No TESTS Drain Reading of gauge located near water Residual pressure with valve in test test Supply test connection: N/Apsi N/A connection open wide: N/A psi Underground mains and lead-in connections to system risers Other,explain:Tenant work flushed before connection made to sprinkler piping: only! Verified by copy of the Contractor's Material and Test Certificate for Underground Piping Yes No Flushed by installer of underground sprinkler piping Yes No BLANK TESTING Number used: Locations: N/A Number removed: GASKETS N/A CUTOUTS All cutout discs have been removed from all sprinkler piping X Yes No If no,explain: DISCS Welding piping Yes X No If yes: Do you certify as the sprinkler contractor that welding procedures comply with the requirements of at least AWS 132.1? X Yes ❑No WELDING Do you certify that the welding was performed by welders qualified in compliance with the requirements of at least AWS 132.1? XYes ONo Do you certify that the welding was carried out in compliance with a documented quality control procedure to ensure that all discs are retrieved, that openings in piping are smooth,that slag and other welding residue are removed and that the internal diameters of piping are notpenetrated? X Yes ❑No FORWARD TEST Backflow device forward tested at a minimum of the highest Test readings: OF BACKFLOW challenge system demand plus inside hose stream allowance(if (see attached memo) applicable) Yes No psi_N/A gpm N/A HYDRAULIC Placed on system riser(s) Yes X No If no,explain:TENANT WORK ONLY DATA NAMEPLATE REMARKS Date left in service with all control valves open: 10/28/25 Name of sprinkler contractor: Blackwater Services Group LLC. Contractor's address: 117 Great Hill Road SIGNATURES City:Naugatuck State:CT Zip:06770 Tests witnessed b Property owner/Age Title: Date: Sprinkler r: M.Uszakiewicz JR. Title:OYTer Date: AHJ Title: Date: 49 i r r 10 4 y�.0 do g JOIL- '3AM �siv� SYSTEM RECORD OF COMPLETION our Logo Mere Form Completion Date:11/18/2025 _ Supplemental Pages Attached:_ 1. PROPERTY INFORMATION Name of property:Quintessential Mortgage Address:3 International Dr.Rye Brook NY Description of property:Commercial Name of property representative: Address: Phone: Fax: E-mail: 2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor:Healy ELctrical Contracting Corp Address:1 Zeiss Dr.Thomwood NY 10594 Phone:914-804-3039 Fax: E-mail: Service organization:Open Systems Metro Address:258 Route 117 By-Pass Rd.Bedford Hills Ny 10507 Phone:914-241-0057 Fax:914-241-0058 E-mail:service@osmetro.com Testing organization:Open Systems Metro Address:258 Route 117 By-Pass Rd.Bedford Hills Ny 10507 Phone:914-241-0057 Fax:914-241-0058 E-mail:service@osmetro.com Effective date for test and inspection contract: Monitoring organization: Address: Phone: Fax: E-mail: Account number: Phone line 1: Phone line 2: Means of transmission: Entity to which alarms are retransmitted: Phone: 3. DOCUMENTATION On-site location of the required record documents and site-specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: O New system m Modification to existing system Permit number: NFPA 72 edition: 2019 4.1 Control Unit Manufacturer:Edwards Model number:EST-3 4.2 Software and Firmware Firmware revision number: 4.3 Alarm Verification m This system does not incorporate alarm verification. Number of devices subject to alarm verification: Alarm verification set for seconds NFPA 72(p.1 of 3) 1 ©2018 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized NFPX use,contact licensing@nfpa.org. SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel:110v Control panel amps: Overcurrent protection: Type:Breaker Amps: 20 Branch circuit disconnecting means location: Number: 5.1.2 Secondary Power Type of secondary power: Battery Location,if remote from the plant: Calculated capacity of secondary power to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 5 5.2 Control Unit m This system does not have power extender panels m Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Dual Media Separate Survivability Pathway Type Pathway Pathway Class Level Signaling Line Device Power Initiating Device Notification Appliance Other(specify): 7. REMOTE ANNUNCIATORS Type Location 8. INITIATING DEVICES Addressable or Alarm or Sensing Type Quantity Conventional Supervisory Technology Manual Pull Stations Smoke Detectors 51 Addressable Alarm Photo Duct Smoke Detectors Heat Detectors 1 Addressable Alarm Fixed Gas Detectors Carbon Monoxide Detectors Waterflow Switches Tamper Switches NFPA 72(p.2 of 3) ©2018 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized Hill use,contact licensing@nfpa.org. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visual 7 Strobe Combination Audible and Visual 5 Horn/Strobe 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices HVAC Shutdown Fire/Smoke Dampers Door Unlocking Elevator Recall Elevator Shunt Trip 11. INTERCONNECTED SYSTEMS p This system does not have interconnected systems. O Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: A.-� Printed name: -gaoL k& Date: I O Organ tion: 14-IOL&"/ ��0 � Title:�-'l-1�M4 z4yll- Phone: 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed:Charlie Carpenter Printed name: Charlie Carpenter Date: 11/18/2025 Organization:Open Systems Metro Title: Fire Alarm Tech Phone: 914-241-0057 12.3 Acceptance Test I Date and time of acceptance test: 1^n Installing contractor representative: �i A-L Testing contractor representative: Property representative: AHJ representative: NFPA 72(p.3 of 3) ` ©2018 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized use,contact licensing@nfpa.org. COMcheck Software Version COMcheckWeb Interior Lighting Compliance Certificate Project Information f ILE Copy Energy Code: 2020 NYStretch Energy Code - 2018 IEC Project Title: Quintessentials Project Type: Alteration Construction Site: Owner/Agent: Designer/Contractor: Allowed Interior Lighting Power A B C D Area Category Floor Area Allowed Allowed (ft2) Watts / ft2 Watts 1-Office 11000 0.69 7590 Total Allowed Watts = 7590 Proposed Interior Lighting Power A B C D E Fixture ID : Description / Lamp / Wattage Per Lamp / Ballast Lamps/ # of Fixture (C X D) Fixture Fixture Watt. Office (11000 sp.ft.) LED: F1: 2x4: Other: 1 26 27 710 LED: F2: 2x2: Other: 1 21 24 508 LED: F3: 4" Rec: Other: 1 26 14 377 LED: F4: 8' linear: Other: 1 23 64 1472 LED: F5: 6' linear: Other: 1 5 48 240 LED: M 8' Rec: Other: 1 10 64 640 LED: F7: 6' Rec: Other: 1 5 48 240 LED: F8: Square: Other: 1 50 7 350 Total Proposed Watts = 4537 Interior Lighting PASSES Interior Lighting Compliance Statement Compliance Statement: The proposed interior lighting alteration project represented in this document is consistent with the building plans,specifications, and other calculations submitted with this permit application.The proposed interior lighting systems have been designed to meet the 2020 NYStretch Energy Code- 2018 IECC requirements in COMcheck Version COMcheckWeb and to comply with any applicable mandatory require din the Inspection Checklist. of NE{q. Antonio Pellegrino, PE P��`�o PE yo 06-16-25 Name-Title Signature *PO t 9Z * Date O w W Z 2 2� �o �9790 F, v OFESSIONP Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 1 of 8 COMcheck Software Version COMcheckWeb Mechanical Compliance Certificate Project Information Energy Code: 2020 NYStretch Energy Code - 2018 IECC Project Title: Quintessentials Location: Rye Brook, New York Climate Zone: 4a Project Type: Alteration Construction Site: Owner/Agent: Designer/Contractor: Mechanical Systems List Quantity System Type & Description 1 EWH-1: Electric Storage Water Heater, Capacity: 10 gallons No minimum efficiency requirement applies 2 EWH-2&3: Electric Storage Water Heater, Capacity: 20 gallons No minimum efficiency requirement applies Mechanical Compliance Statement Compliance Statement: The proposed mechanical alteration project represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit application.The proposed mechanical systems have been designed to meet the 2020 NYStretch Energy Code-2018 IECC requirements in COMcheck Version COMcheckWeb and to comply with any applicable mandatory requirements listed in the Inspection Checklis Antonio Pellegrino, PE oF NE{1,y 06-16-25 Name-Title Signature *CO �p 0,9Z* Date o W W Z O oA �9792e �1i2 v oFESS1oNr Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 2 of 8 COMcheck Software Version COMcheckWeb Inspection Checklist Energy Code: 2020 NYStretch Energy Code - 2018 IECC Requirements: 100.0% were addressed directly in the COMcheck software Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section # Plan Review Complies? Comments/Assumptions & Reci ID C103.2 Plans, specifications, and/or ❑Complies Requirement will be met. [PR3]1 calculations provide all information ❑Does Not with which compliance can be determined for the service water ❑Not Observable heating systems and equipment and ❑Not Applicable document where exceptions to the standard are claimed. Hot water system sized per manufacturer's sizing guide. C103.2 Plans, specifications, and/or ❑Complies Requirement will be met. [PR4]1 calculations provide all information ❑Does Not with which compliance can be determined for the interior lighting ❑Not Observable and electrical systems and equipment ❑Not Applicable and document where exceptions to the standard are claimed. Information provided should include interior lighting power calculations, wattage of bulbs and ballasts,transformers and control devices. C405.10 New parking garages and new parking ❑Complies [PR38]3 lots powered by the energy services ❑Does Not for a building, and with 10 or greater parking spaces, provide either: 1. ❑Not Observable Panel capacity and conduit for the ❑Not Applicable future installation of minimum 208/240V 40-amp outlets for 5 percent of the total parking spaces and not less than two parking spaces; or 2. Minimum 208/240V 40-amp outlets for 5 percent of the total parking spaces and not less than two parking spaces. Additional Comments/Assumptions: 111 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 3 of 8 Section # Plumbing Rough-in Inspection Complies? Comments/Assumptions & Reg.1 C404.5, Heated water supply piping conforms ❑Complies Requirement will be met. C404.5.1, to pipe length and volume ❑Does Not C404.5.2 requirements. Refer to section details.[PL6]3 ❑Not Observable ❑Not Applicable C404.6.3 Pumps that circulate water between a ❑Complies Exception: Requirement does not apply. [PL7]3 heater and storage tank have controls ❑Does Not that limit operation from startup to <= 5 minutes after end of heating ❑Not Observable cycle. ❑Not Applicable C404.7 Demand recirculation water systems ❑Complies Exception: Requirement does not apply. [PL8]3 have controls that start the pump ❑Does Not upon receiving a signal from the action of a user of a fixture or ❑Not Observable appliance and limits the temperature ❑Not Applicable of the water entering the cold-water piping to 104°F. Additional Comments/Assumptions: 111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 4 of 8 Section # Mechanical Rough-In Inspection Complies? Comments/Assumptions & Req.ID C402.2.6 Thermally ineffective panel surfaces of ❑Complies Exception: Requirement does not apply. [ME41]3 sensible heating panels have ❑Does Not insulation >= R-3.5. ❑Not Observable ❑Not Applicable C405.8.1. New traction elevators with a rise of ❑Complies Exception: Requirement does not apply. 1 75 feet or more have a power ❑Does Not [ME36]3 conversion system that complies as follows: C405.8.1.1.1 Induction motors ❑Not Observable with a Class IE2 efficiency ratings are ❑Not Applicable be used. C405.8.1.1.2 Transmissions does not reduce the efficiency of the combined motor/transmission below that shown for the Class IE2 motor for elevators with capacities below 4,000 lbs. C405.8.1.1.3 Potential energy released during motion recovered with a regenerative drive that supplies electrical energy to the building electrical system. C405.9 Commercial kitchen equipment shall ❑Complies Exception: Requirement does not apply. [ME37]3 comply with the minimum efficiency ❑Does Not requirements of Tables C405.9(1) through table C405.9(5). ❑Not Observable ❑Not Applicable C403.7.2 Enclosed parking garage ventilation ❑Complies Exception: Requirement does not apply. [ME115]3 has automatic contaminant detection ❑Does Not and capacity to stage or modulate fans to 50%or less of design capacity. ❑Not Observable ❑Not Applicable C403.7.5 Kitchen exhaust systems comply with ❑Complies Exception: Requirement does not apply. [ME116]3 replacement air and conditioned ❑Does Not supply air limitations, and satisfy hood rating requirements and maximum ❑Not Observable exhaust rate criteria. See section ❑Not Applicable details. C403.4.1. Heating for vestibules and air curtains ❑Complies Exception: Requirement does not apply. 4 with integral heating include ❑Does Not [ME63]2 automatic controls that shut off the heating system when outdoor air [-]Not Observable temperatures > 45F.Vestibule ❑Not Applicable heating and cooling systems controlled by a thermostat in the vestibule with heating setpoint <_ 60F and cooling setpoint >= 85F. C403.10, Refrigerated display cases, walk-in ❑Complies Exception: Requirement does not apply. C403.10.1 coolers or walk-in freezers served by ❑Does Not remote compressors and remote C403.10.2 condensers not located in a ❑Not Observable [ME123]3 condensing unit, have fan-powered ❑Not Applicable condensers that comply with Sections C403.5.1 and refrigeration compressor systems that comply with C403.5.2.. Additional Comments/Assumptions: 111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 5 of 8 Section # Rough-In Electrical Inspection Complies? Comments/Assumptions & Re .ID C405.2.2. Spaces required to have light- ❑Complies Requirement will be met. 2 reduction controls have a manual ❑Does Not [EL22]1 control that allows the occupant to reduce the connected lighting load in ❑Not Observable a reasonably uniform illumination ❑Not Applicable pattern >= 50 percent. C405.2.1, Occupancy sensors installed in ❑Complies Requirement will be met. C405.2.1. classrooms/lecture/training rooms, []Does Not 1 conference/meeting/multipurpose [EL18]1 rooms, copy/print rooms, ❑Not Observable corridor/transition areas, ❑Not Applicable lounges/breakrooms, enclosed offices, open plan office areas, restrooms, storage rooms, locker rooms, warehouse storage areas, and other spaces <= 300 sgft that are enclosed by floor-to-ceiling height partitions. Reference section language C405.2.1.2 for control function in warehouses and section C405.2.1.3 for open plan office spaces. C405.2.1. Occupancy sensors control function in ❑Complies Exception: Requirement does not apply. 2 warehouses: In warehouses, the ❑Does Not [EL19]1 lighting in aisleways and open areas is controlled with occupant sensors that Not Observable automatically reduce lighting power ❑Not Applicable by 50%or more when the areas are unoccupied.The occupant sensors control lighting in each aisleway independently and do not control lighting beyond the aisleway being controlled by the sensor. C405.2.1. Occupant sensor control function in ❑Complies Requirement will be met. 3 open plan office areas: Occupant ❑Does Not [EL20]1 sensor controls in open office spaces ❑Not Observable >= 300 sq.ft. have controls 1) configured so that general lighting can ❑Not Applicable be controlled separately in control zones with floor areas <= 600 sq.ft. within the space, 2) automatically turn off general lighting in all control zones within 20 minutes after all occupants have left the space, 3) are configured so that general lighting power in each control zone is reduced by >= 80%of the full zone general lighting power within 20 minutes of all occupants leaving that control zone, and 4) are configured such that any daylight responsive control will activate space general lighting or control zone general lighting only when occupancy for the same area is detected. C405.2.2, Each area not served by occupancy ❑Complies Requirement will be met. C405.2.2. sensors (per C405.2.1) have time- ❑Does Not 1, switch controls and functions detailed C405.2.2. in sections C405.2.2.1 and C405.2.2.2. ❑Not Observable 2 ❑Not Applicable [EL21]z 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 6 of 8 Section # Rough-In Electrical Inspection Complies? Comments/Assumptions & Recl.ID C405.2.3, Daylight zones provided with ❑Complies Requirement will be met. C405.2.3. individual controls that control the ❑Does Not 1, lights independent of general area C405.2.3. lighting within daylight zones in the ❑Not Observable 2 following spaces: 1. Spaces with a ❑Not Applicable [EL23]2 total of more than 100 watts of general lighting within sidelit zones complying with Section C405.2.3.2. General lighting does not include lighting that is required to have specific application control in accordance with Section C405.2.4. 2. Spaces with a total of more than 100 watts of general lighting within toplit zones complying with Section C405.2.3.3. See code section C405.2.3.1 Daylight responsive control function and section C405.2.4 Separate lighting control devices for ❑Complies Requirement will be met. [EL26]1 specific uses installed per approved ❑Does Not lighting plans. ❑Not Observable ❑Not Applicable C405.2.4 Additional interior lighting power ❑Complies Requirement will be met. [EL27]1 allowed for special functions per the ❑Does Not approved lighting plans and is automatically controlled and ❑Not Observable separated from general lighting. ❑Not Applicable C405.3 Exit signs do not exceed 5 watts per ❑Complies Requirement will be met. [EL6]1 face. ❑Does Not ❑Not Observable ❑Not Applicable C405.6 Low-voltage dry-type distribution ❑Complies [EL26]2 electric transformers meet the ❑Does Not minimum efficiency requirements of Table C405.6. ❑Not Observable ❑Not Applicable C405.7 Electric motors meet the minimum ❑Complies [EL27]2 efficiency requirements of Tables ❑Does Not C405.7(1)through C405.7(4). Efficiency verified through certification ❑Not Observable under an approved certification ❑Not Applicable program or the equipment efficiency ratings shall be provided by motor manufacturer(where certification programs do not exist). C405.8.2 Escalators and moving walks comply ❑Complies [EL28]2 with ASME A17.1/CSA B44 and have ❑Does Not automatic controls configured to reduce speed to the minimum ❑Not Observable permitted speed in accordance with ❑Not Applicable ASME A17.1/CSA B44 or applicable local code when not conveying passengers. C405.9 Total voltage drop across the ❑Complies [EL29]2 combination of feeders and branch ❑Does Not circuits <= 5%. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 7 of 8 Section # Final Inspection Complies? Comments/Assumptions & Re .ID C303.3, Furnished 0&M instructions for ❑Complies Requirement will be met. C408.2.5. systems and equipment to the ❑Does Not 2 building owner or designated [FI17]3 representative. ❑Not Observable ❑Not Applicable C404.3 Heat traps installed on supply and ❑Complies Requirement will be met. [FI11]3 discharge piping of non-circulating ❑Does Not systems. ❑Not Observable ❑Not Applicable C404.4 All piping insulated in accordance with ❑Complies Requirement will be met. [F125]2 section details and Table C403.11.3. ❑Does Not ❑Not Observable ❑Not Applicable C405.4.1 Interior installed lamp and fixture ❑Complies See the Interior Lighting fixture schedule for values. [F118]1 lighting power is consistent with what ❑Does Not is shown on the approved lighting plans, demonstrating proposed watts ❑Not Observable are less than or equal to allowed ❑Not Applicable watts. C408.1.1 Building operations and maintenance ❑Complies [F157]1 documents will be provided to the ❑Does Not owner. Documents will cover manufacturers' information, ❑Not Observable specifications, programming ❑Not Applicable procedures and means of illustrating to owner how building, equipment and systems are intended to be installed, maintained, and operated. C408.3 Lighting systems have been tested to ❑Complies Requirement will be met. [F133]1 ensure proper calibration, adjustment, ❑Does Not programming, and operation. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Quintessentials Report date: 06/16/25 Data filename: Page 8 of 8 Buil Permit Check List&Zoning Anal sis Address: SBL: `2_(_ Zone: .lse: G Const.Type: Other. Submittal Date: 014 2� Revisions Submittal Dates: Applicant: (1 Nature of Work: a_1 e f d t CSZ ��\ Reviews:ZBA: JUL 0 9 2025 P BOT: Other. ( (►'�FEES:Filing. ` j0: Flood Plane: Legalization: ( ) (."P: Dated otarized SBL: Tnus I.D. Cross Connection: H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm 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: Electronic Other. (� ( ) License: Workers Comp: Liability Comp.Waiver. Other. ( ) ( ) CODE 753#: Dated N/A: 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. ( � ( ) FIRE SUPPRESSION:Plans: Permit: N/A Other. (►� ( ) H.V.A.C.: Plans: Permit N/A: Other. ( ) ( ) FUEL TANK:Plans: Permit: Fuel Type: Other. ( ) (o 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 EX191ING PROPOSED NOTES APPROVED Area: Date: JUL 1 1 2025 Circle: Fie Front: Front: Sides: Rear. Main Cor. Accs.Cov: Ft.H Sb: Sd.H Sb: GFA: Tot : Ft.Im pgkiw. HeigbtZSton notes: _ Page 1 of 2 ACO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/30/2024 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 endorsements. PRODUCER NAME:N 1PPM Cartitioate Center NAME;_ Willie Towers Watson Northeast, Inc PHONE -- ----- c/o 26 Century Blvd WVC.NO 1-377-945-7373 FAVC.X No), 1-480-467-2318 P.0 Bo: 305191 -MAIL oertilticatesortrco.con OREBi: Nashville, TN 372305191 USA INSURER(S)AFFORDING COVBRAOE NISURERA: 2ndurance Anaurance Corporation 11531 INSURED INSURER 6: Sampo Anse lca Insurance Company 11126 DRA Advisors LLC 575 5TH Ave FL 38 INSUREIlC: ACS Property s Casualty Insurance Company 20699 Now York NY 1C017 INSURERO: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W37170591 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 AOOL'BUBRPOLICY EFF POLICY EXPLTR LIMITS X COMMERCIAL GENERALLIABILIY EACH OCCURRENCE _ 6 2,000,000 CLAIMS MADE `X�OCCUR PREMISES Ea oclairranool 6 2,000,000 A X TEIA Included fral MED EXP(Any onspwsort 6 _ Y = uded GGR10010452208 Ii12/31/2024 12/31/2025 PERSONALIADVINJt1RY 6 2,000,000 OEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE < 4,000,000 X POLICY SECT 1WLOC PRODUCTS-COMP/OPAGO 6 4,000,000 OTHER AUTOMOBILE LIABILITY s NGL LIPAT6 11000,000 • M �( ANY AUTO BODILY INJURY(Per person) 6 B OWNED F 1 SCHEDULED Y Y GAA30030321702 12/31/2026 22/31/2025 BODILYINJURY(Per adaldant) 6 AUTOS ONLY AUTOS HIRED NON-OWNED PERTYDAMAGE : AUTOS ONLY AUTOS ONLY Pat S C UIMIRELLA LIAR X. OCCUR EACH OCCURRENCE f 10,000,000 X EXCESS LIAS CLAIMS-MADE I= 072556299 003 12/31/2024 12/31/2025 AGGREGATE_ i$ 10,000,000 DED RETENTIONS f WORKERS COMPENSATION TE ) ERTH AND EMPLOYERS'LIABILITY Yin A ER ' ANYPROPRIE TOR PARTNER'EXECUTIVE E.L.EACH ACCIDENT S OFFICERIMEMBEREXCLUDED� N/A -- -------------- ----- (Mandatory In NMI E.L.DISEASE.EA EMPLOYEE 6 It yes,describe under - -- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT = I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached it more space is regwred) Named Insured includes: 1100 King Associates LLC, Location Address: 1100 King Street 1-6 International Drive, Rye Brook, NY, 10573. Certificate Bolder is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Rye Brook AUTHORIZED REPRESENTATIVE 938 King Street Rye Brook, NY 10573 ►'l11/�,.0. Cc 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD sk n, 27009628 w-,4 3757262 NYSIF New York State Insurance Fund PO Box 66699.Albany. NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A A A A A A 133983707 74 THE FLANDERS GROUP r 300 LINDEN OAKS Y SUITE 210-1ST FLOOR ROCHESTER NY 14625 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER COMFORT MAINTENANCE CORP VILLAGE OF RYE BROOK 1100 KING STREET 938 KING STREET RYE BROOK NY 10573 RYE BROOK NY 10573 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE Z 1048 013-5 495350 01/01/2025 TO 01/01/2026 6/5/2025 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1048 013-5, 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 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 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 SUR NCE FUND T �V DIRECTOR.INSURANCE FUND UNDERWRITING VALIDATION NUMBER:286024627 U-26.3 CARE&WA-01 MGIORDANO A�O�R�• CERTIFICATE OF LIABILITY INSURANCE DATE 2/20 5 4/ /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 endorsements). PRODUCER CONTACT Michelle Giordano 00 BeaAssuredPartners New rd Saw ne Mill Road gland,Inc. PHONE ) FAX A/C,No,Ext: 860 426-6163 ac,No: 860 426-6163 Shelton,CT 06484 E-MAIL .Michelle.Giordano a�4ssuredPartners.com INSURERS AFFORDING COVERAGE NAIC# INsuR_ I-:Selective Insurance Company of NY 13730 INSURED INSURERS:MS Transverse Specialty Insurance Company 41807 Carey&Walsh,Inc. INSURER c:AmTrust Insurance Company 15954 P.O.Box 2529 INsuRER D:Hartford Life&Accident Ins.Co. 70815 Briarcliff Manor,NY 10510-1511 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. ILTR NSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICV EFF POLICY EXP LIMITS A X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 CLAIMS-MADE DE OCCUR X X $ 2509239 1 9/1/2024 9/1/2025 DAMAGE TO RENTED $ 500,000 MED EXP An one rson 10,000 PERSONAL&ADV INJURY 2,00 ,000 rGEINI'LGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000CY�J JET LOC PRODUCTS-COMP/OPAGG $ 4,000,000ER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO X X S 2509239 9/1/2024 9/1/2025 BODILY INJURY Per person) Is OWNED SCHEDULED AUTOS ONLY AUTOS pp BODILY INJURY Per accident S AUTOS ONLY AUTOS ME. Per aE ant AMAGE $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5,000,000 EXCESS LIAB CLAIMS-MADE X X TSCEEX000344-00 9/1/2024 9/1/2025 AGGREGATE 5,000,000 DED RETENTION$ Is C WORKERS COMPENSATION X PER OTH- ANDEMPLOYERTLIABILITY OWC1011944 4/1/2025 4/1/2026 OFFR FICERIMEM ER EXCLUDED?ECUTIVE Y� N/A X 1,000,000 E.L.EACH ACCIDENT (Mandatory in and E.L.DISEASE-EA EMPLOYE 1,000,000 0 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1,000,000 D NY Disability LNY612715 41112125 1/31/2026 Statutory J DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) Coverage: Pollution Liability Insured: Berkley Insurance Company(NAIC 32603) Policy#FEI-ECC-27778-04 Effective Date:9/1/2024 Expiration Date:9/1/2025 Liability Limit per Occurrence$1,000,000 Aggregate$2,000,000 SEE ATTACHED ACORD 101 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 938 King Street ACCORDANCE WITH THE POLICY PROVISIONS. Rye Brook,NY 10573 AUTHOR11ZEDD REPRESENTATIVE ACORD 25(2016/03) a ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD oRK Workers' CERTIFICATE OF TATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1a.Legal Name&Address of Insured(use street address only) 1b. Business Telephone Number of Insured Carey&Walsh,Inc. (914) 762-9600 P 529 N. Stateto Road P.O.Box 1c. NYS Unemployment Insurance Employer Registration Number of Insured R Briarcliff Manor,NY 10510-1511 1d. Federal Employer Identification Number of Insured or Social Security ork Location of Insured(Only required if coverage is specifically limited to Number certain locations in New York State,i.e.,a Wrap-Up Policy) 13-2591740 2.Name and Address of Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) mTrust Insurance Company Village of Rye Brook 3b. Policy Number of Entity Listed in Box"1a" 938 King Street OWC1011944 Rye Brook, NY 10573 3c. Policy effective period /1/2025 to 4/1/2026 3d. The Proprietor,Partners or Executive Officers are ® included.(Only check box if all partnerstofficers included) Dail excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"T'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 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: Michelle Giordano (Print name of authorized representative or licensed agent of insurance carrier) (-17�t.�lcf!fC Approved by: 04/02/2025 (Signature) (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: 860-426-6163 • i81111 BLACSER-03 JGRABOWSKI 144lI?L> CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) �� 7/21 21/2/2025 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 endorsemen s. PRODUCER C NTACT World Insurance Associates,LLC PHONE FAX 2725 Whitney Ave AIc,No,Ext:(203)281-1123 (A/C,No): Hamden,CT 06518 Rffilk INSURERS AFFORDING COVERAGE NAIC N INSURER A:Arch Prope Casualty Insurance Company 10946 INSURED INSURER B:Arch Indemnity Insurance Company 30830 Blackwater Services Group LLC INSURERC:Arch Insurance Company 11150 117 Great Hill Rd INSURERD:W.R. Berkley Corporation Naugatuck,CT 06770 INSURERE:Berkley Assurance Company 39462 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 AIN DL SUBDR POLICY NUMBER POLICY EFF MMfDDfYYYYI MP�DpY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE [X] OCCUR 11 PKG1999201 1/29/2025 1/29/2026 DAMAGE TO R(EaENTED occurrence)REMISES $ 300,000 X No XCU Exclusions MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY�X PE LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER $ A AUTOMOBILE LIABILITY CO aBINED cc'cientiSINGLE LIMIT $ 1,000,000 X ANY AUTO 11PKG1999201 1/29/2025 1/29/2026 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON(JV NED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ B P—DEDTX UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LAB CLAIMS-MADE �.11UFP1999200 1/29/2025 1/29/2026 AGGREGATE $ 101000,000 RETENTION$ 10,000 $ C WORKERS COMPENSATION X ST PERTUTE OTH- AND EMPLOYERS'LIABILITY 11WC11999201 1/29/2025 1/29/2026 1,000,000 ANY PROP RIETOR/PARTNE R/EXECUTIVE Y� N/A E.L.EACH ACCIDENT $ NlFandatory in NHS EXCLUDED? 1,000,000 E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ ' D Equipment Floater CIM5584533-11 1/29/2025 1/29/2026 Stored Materials 500,000 E Prof Poll Liability PCAB-5026322-0125 1/29/2025 1/29/2026 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/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 Village of Rye Brook THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook,NY 10573 — AUTHORIZED REPRESENTATIVE lake ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1 b. Business Telephone Number of Insured Blackwater Services Group, LLC 475-269-3473 117 Great Hill Road Naugatuck,CT 06770 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 84-3744552 2. Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Arch Insurance Village of Rye Brook 3b.Policy Number of Entity Listed in Box"'Ia" 938 King Street 11 WC11999201 Rye Brook, NY 10573 3c. Policy effective period 01/29/2025 to 01/29/2026 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: Jillian Grabowski (Print name of authorized representative or licensed agent of insurance carrier) Approved by: 94C� �uc(yBG 07/21/2025 (Sig ture) (Date) Title: Account Executive Telephone Number of authorized representative or licensed agent of insurance carrier: 203-281-1 123 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 m o a- ci in: r- CDJ z 0 f— z`' Zzo M W ) ��w 't3S w W O V w w N O-U W .J W 'tOa Q F- � W = v > ,zb p D o W w (D(n a. 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