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HomeMy WebLinkAboutRB25-0018VILLAGE OF RYE BROOK - BUILDING DEPARTMENT 938 KING STREET- RYE BROOK, NY (914)939-0668 1 www.ryebrook.org HVAC / Heating (Remodel) Permit PERMIT#: RB25-0018 ISSUED: 10/07/2025 EXPIRES: ADDRESS: 46 HILLANDALE RD PARCEL ID #: 130.77-1-22 PARTIES: Applicant Property owner Westmore Fuel Company, Inc. Lee Velta Dominick Bologna 46 Hillandale Rd 86 N. Water St Rye Brook, NY 10573 Greenwich, CT 06830 License number WC-33077-H2O NOTICE 1. MUST BE CONSPICUUSLY POSTED2.ACIOPYOFIT THE PROVEDPLANOMU TBEKEPTOTNSITE. THE BSITE. 10/07/2026 Hours of Operation of Construction Equipment/ Village Code §158-4: WEEKDAYS - 8:00am to 6:00pm or dusk, whichever is earlier; SATURDAYS - 9:00am to 4:00pm; - SUNDAYS & HOLIDAYS -No Construction Activity Allowed This permit is valid for a period not to exceed twelve (12) months from the date of issuance, and covers only that work listed above. Separate permits are required for any electrical, plumbing, fire suppression, fire/smoke/carbon monoxide detectors/alarms, or any other work not covered under this permit. The approved plans must be kept on the job site & be made available for review by the Building Department upon demand. Any amendments or changes to the approved plans must be designed by your architect/engineer and submitted to the Building Department for review and approval prior to performing the work. Steven E. Fews- Building& Fire Inspector #BR,HVAC 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 Scope of Work: Replacement # of Units: List Equipment: Location of Equipment: Method of Installation/Removal: 1 Oil fired hot water boiler Basement Assorted and and power tools all needed to HVAC Permit Application, page 1 / 1 �yE 6Rnv� VILLAGE OF RYE BROOK F 2m 938 King St Rye Brook, NY 10573 W Phone: (914)939-0668 1 www.ryebrookgov Building Department HVAC / Heating (Remodel) Permit Permit Set46 HILLANDALE RD P# RB25-0018 R# 130.77-1-22 PERMIT INFORMATION Address Permit number Date issued 46 H I LLAN DALE RD RB25-0018 10/07/2025 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 Contractor's Workers Compensation Insurance (Showing Rye Brook Cent Holder 4-5 Westchester Home Improvement License v Property Owner/Homeowner Government ID, and/or Proof of Ownership 7 Mechanical Equipment Specifications pages 8-9 Contractor's Liability Insurance 10-13 HVAC Permit Application 14 Building Department. 938 King St Rye Brook, NY 10573 / Phone: (914)939-0668 VILLAGE OF RYE BROOK 938 King St Rye Brook, NY 10573 Phone: (914)939-06681y ..ryebrook.gov Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQU I RED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit includingthe site gradingand the surveyor'sfinal grading certificate. George Latimer NN—esLl Ster James Maisano Westchester County Executive nunt`r Director, Consumer Protection Department of Consumer Protection Home Improvement License WESTMORE FUEL COMPANY, INCORPORATED 86 NORTH WATER STREET GREENWICH,CT-06830 This license is issued in accordance with Article XVI of the Westchester County Consumer Protection Code and is valid only upon) presence of the official department seal. Proof of citizenship or immigration status is not required for issuance of this license. NOT FOR FEDERAL PURPOSES �EConsu� License Number �� Date of Expiration WC-33077-H2O ca 08/18/2026 LITHO IN U.5 A. Cpn�aCF`c c.r— ` 0.5' r(;r 2(k STATE OF NEVt fi'6RK COUNTY OF ) as: A-rT r, it !` �2.�'c-/H being duly swom, deposes and states that he/she is the applicant above named, (print name of individuall 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 snake 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 the this Sai—� day of krv. t) C r 120 aS 4 Udei') Signature of Property Owner ZaC- VC L,? I Print_Name-f Property Owner Notary Public SEAN LYTLE NOTARY PUBLIC STATE OF CONNECTICUT MY COMMISSION EXPIRES AUG. 31, 2030 Sworn to before me this S day of;� tt,'L r r 20 Slgnature of Applicant 4�1�IQ�rn Print fApplicant Notary Public SEAN LYTLE NOTARY PUBLIC STATE OF CONNECTICUT MY COMMISSION EXPIRES AUG. 31, 2030 'Phis 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 retumed to the applicant. 7/1/2025 EM 1.0 GPH MAX EK2 1.75 GPH MAX PRODUCT DATA SHEET PRODUCT DATA SHEET System 2000 - Energy Kinetics' hybrid oilheat I system for every home! 1_ ENER YY STAR It's got to be SYSTEM 2000 Call us today for 800-661-0902 more information www.systeM2000.Com ► 4d System 2000 is an integrated heat and hot water system - makes both heat and hot water! Homeowners enjoy economical heat, plus a virtually endless supply of hot water with lower energy costs throughout the year. Plus, System 2000 delivers significant savings over electric or traditional hot water making methods, with whisper quiet operation. ..w No chimney needed! Ground level venting stays relatively cool! 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THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this Certificate does not Confer rights to the certificate holder in lieu of such endorsement($). PRODUCER CONTACT NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 PHONE (A/C, No, Ert): 888-333-4949 I FAX (A/C, No): 507-4464664 OWATONNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED INSURER B: FEDERATED RESERVE INSURANCE COMPANY 16024 WESTMORE FUEL COMPANY INCORPORATED 86 N WATER ST INSURER C: INSURER D: GREENWICH, CT 06830-5886 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 35 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYY POLICY EXP MMIDDIYYY LIMITS A X COMMERCIAL GENERAL UABRJTY CLAIMS -MADE OCCUR N N 9062818 06/01/2025 06/01/2026 EACH OCCURRENCE $1,ODO,000 DAMAGE TO. Ea p=E O e m RENTED PREMISES $100,000 MED EXP (Any one person) $5,000 PERSONAL I ADV INJURY $1,DDO,000 GENT X AGGREGATE LIMIT APPLIES PER: POLICY �E�T ❑ LOC OTHER: GENERAL AGGREGATE $2 ODO OOO PRODUCTS S COMPIOP ACC $2,000,000 BOWNED AUTOMOBILE LIABILITY JANYAUTO AUTOS ONLY SCHEDULED OS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY N N 9062815 06/01/2025 06/01/2026 COMBINED SINGLE LIMIT (Ea accident) $1,000000 BODILY INJURY (Per Person) BODILY INJURY (Per Accident) ROPERTY AMAGE Par Acddm B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 9062816 06/01/2025 06/01/2026 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 'NX ANY PROPRIETORIPARTNER/ EXECUTIVE (Mancl RIMEMBNH EXCLUDED? (MarERIMEin NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A N 9917566 06/01/2025 06/01/2026 PER STATUTE HER E.L EACH ACCIDENT $500,000 E.L DISEASE EA EMPLOYEE $500,000 E.L DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be afbched if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION RYE BROOK, NY 10573-1226 350 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ,UL © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 Of 1 AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY WESTMORE FUEL COMPANY INCORPORATED 86 N WATER ST GREENWICH, CT 06830-5886 POLICY NUMBER SEE CERTIFICATE # 35.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 35.0 SEE CERTIFICATE # 35.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE SECONDARY POLICY(S) General Liability N N 9062815 06/01/2025 06/01/2026 EACH OCCURRENCE $1,000J000 DMG TO RNT PREM EA OCC $100J000 MED EXP-ANY ONE PERSON 55,000 PERSONAL & ADV INJURY 51,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGG $2,000,000 ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD vORIK Workers' STATE Compensation Board CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE la. Legal Name & Address of Insured (use street address only) 1b. Business Telephone Number of Insured 203-531-6800 Westmore Fuel Company Incorporated 86 N Water St Greenwich, CT 06830-5886 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured (Only required if coverage is specifically limited to 1d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State, i.e., a Wrap -Up Policy) Number 06-0739367 2. Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Federated Reserve Insurance Company Village Of Rye Brook #35 3b. Policy Number of Entity Listed in Box "l a" 938 King St 9917566 Rye Brook NY 10573-1226 3c. Policy effective period 06/01/2025 to 06/01/2026 3d. The Proprietor, Partners or Executive Officers are included. (Only check box if all partners/officers included) ❑X 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 "l 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: Elizabeth Petersen (Print name of authorized representative or licensed agent of insurance carrier) Approved by: � � ^`04/22/2025 (Signature) (Date) Title: Authorized Representative Telephone Number of authorized representative or licensed agent of insurance carrier: 888-333-4949 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov