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HomeMy WebLinkAboutPP26-007 a a i� O 0 � s Lin cn cn a uo OQ q z V z cn x z Ln °; =� 3 sm Ln z ¢ "" o U � w z 02 c!� W � � 94 o4 �)k� BUIL E MENT VIL E OF RYE OK BAN 1 4 2G2 938 KIN ET RYE B ,NY 10573 W ov PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP #: Z PP#: 2(,,-C)C> r Approval Date. AN O? Permit Fee: $ Approval Signature: Disapproved: (fees are non-rerundabk) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING. INSPECTOR.THE ADMIN ISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing;this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes.1.Address: L. 1� F, SBL: f p` — �f Zone: /e 2 2.Proposed Work: t - -• , h? 3.Property Owner: QQ�1- '�( 7 f l.A%3� Address: Cj /U {1- ,J /-� ✓ Phone#: ` if P 30_3 Cell#: email: 07,4 J4 Aej 6, 6r,4- ) 4.Master Plumber: 0—IJ�1 h1e A-1-1 t Address: ;3 Gam.�0 OttiJ& Lie.#: OfT Phone#: 14- wb' S.Y JIell#: email: Company Name: J?�,C-L4 ; C'' ea/" t,sf h - Address: 4.4ASJL . INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location 'Water Urinals Drinking Sinks Showers Bath Laundry domestic Fire Sanitary NaturaU Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 st Floor 2nd Floor 31d Floor 4"s Floor 51 Floor Exterior 5.* List Other Equipment/Provide Dtails: 1 C©ST 411/9, 01 (Notarized Signatures Required Next 2 Pages) -1- 611/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Sworn to before me this day of 120 day of 20 Signature of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant Notary Public Notary Public This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. _2_ 6/1/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: L t °► i 4 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 Mechanical Equipment 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 iijA Sworn to efore me this 1144 day of Q.�pt� day of , 20)-- Signature of Property Owner t nature of Applicant Print Name of Property Owner Print Name of Applicant otary Public Notary Public 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. DEOUNA BARON-DANIEL NOTARY PUBLIC,STATE OF NEW YORK Rcgistration No.OIBA0032W Qualified in Wevch Co My Commission Expires 6/112024 BRADFORD MITE` W A T E R H E A T E R S Residential Atmospheric Vent Gas Water Heater The Atmospheric Vent FV►R Defender Safety System'Models Feature: �1 ■ Bradford White ICON System"*—Intelligent gas control with proven millivolt I__ powered technology and built-in piezo igniter.A standard,off-the-shelf thermopile converts heat energy from the pilot flame into electrical energy to operate the gas valve and microprocessor. No need for extemal electricity. — Enhanced Performance—Proprietary algorithms provide enhanced First Hour Rating and tighter temperature differential. —Advanced Temperature Control System—Microprocessor controls burner operation for consistent and accurate water temperature levels up to 160'F (71°C). — Intelligent Diagnostics—Exclusive multicolor LED light indicates operation status/service required. ■ Defender Safety System°— Designed to be the safest,most reliable flammable vapor ignition resistant system in the industry with a proven track record since 2003. —Advanced ScreenLok®Technology Flame Arrestor Design—Flame arrestor is designed to prevent fgnition of flammable vapor outside of the water heater, -- Resettable Thermal Switch—Proven and reliable bimetallic switch prevents burner and pilot operation in case of ongoing flammable vapors burning inside of the combustion chamber or restricted air flow. —Maintenance-Free—No regular cleaning of air Inlet openings or flame arrestor is required under normal conditions. —Sight Window—Offers a view into the combustion chamber to observe the operation of the pilot and burner. ■ Vitraglas® Lining with Microban —An exclusively engineered enamel formula that provides superior tank protection from the corrosive effects of water; and with Microban®antimicrobial product protection to help prevent the growth of bacteria, mold and mildew on the surface of the tank lining. ■ Hydrojeto Total Performance System--Sediment reducing device that also �a increases first hour rating of hot water while minimizing temperature build-up in tank. ■ 3x4"Snap Lock" Draft Diverter—Allows either 3" (76mm)or 4" (102mm)vent connections with inputs of 40,000 BTU/Hr. or less.Over 40,000 BTU/Hr. has the _ 4" (102mm)"Snap Lock" Draft Diver-ter. v4 t t � ■ Water Connections—NPT factory installed dielectric waterway with heat traps. ■ Protective Anode Rod—Provides added protection against corrosion for long- Photo is of term,trouble-free service. RG240T6N ■ Low Restrictive Brass Drain Valve—Durable tamper proof design. ■ NOx Emissions—Less than 40 ng/J. FEATURING. ■ Small Diameter Models Available—for limited space installations. r ■ T&P Relief Valve—Installed. 1 CQ� ^'44`T3rf7�v1 System ...,. . ..�. ,,,..�.,.., 'May vary by region MICROBAn�, B or 10-Year Limited Tank Warranties/6 or 10-Year Limited Warranty on Component Parts. ' For more information on warranty, please visit www.bradfordwhite.com For products installed m USA,Canada,and Puerto Rico.Some states do not allow limitations on warranties-See complete copy of the warranty included with the heater �•� Microban.antimicrobial product protection helps prevent the growth of bacteria,mold and mildew that may affect the product.The •a/� huil-in antimicrobial properties do not protect users or others from disease-causing organisms.Microbani0 is a registered trademark of Microban Products Company. MANUFACI11RH11INDS.ONE DR MORE OF THE FOLPOWING U.S.PATENS:5.682.660 7,630.976,5,660,165;5,954,492;6,056542.6.9M,280;5,372.185:5.485.M..5.574.822.7.971,560;7,992,526,6,684,821 7,334419;7.866.1% 7.270,087:7,007,748:5,5%fi 952:6,142,216;7,699,TA,,SM1,770;7,337,5i7:i 665211.7,%5,210:7,063.132:7,063.133,7,559,293;7,900,589;5,M3,984,8,082,3M,5,988,117 7,621,238;7,650,959;5,761 379:7,409,925;5,277.171, H-146,772:7 4583 HER 41.2.262.174.OT U.S.AND FOREIGN PA7ENT APPc1CATM PENVNG.0.NifiENT C4t1ADIAN PATENTS.2.314,845,2.504,824,2,106.186:2.143.031;2.409271,2 548.9W..2.112.515;2.476,685;2239,007;2,092,105. 2.107.OT2.Defender Safety System-,ScreenLok•,Hydratet'and Wit agtae are mgistered trademarks of Rradklyd Wtifa"Gorperatlee.IAerobarl'Is a registered trademark of Microban Pra&cb Caoepany. 1101-G-0822 Residential Atmospheric Venn Gas Water Hewer Atmospheric Vent Models Meet or exceed ASHRAE 90.1(latest edttion).C.E.C.Listed NATURAL GAS AND L1OUID PROPANE GAS Recovery efficiency ranging up to 80% Model Rated DOE LP First Uniform Recovery at Model Rated OUE LP First UnO rm Recovery at Number Nominal Rated BTUML BTUMr. Hour Eoergv 901 Rise' Number Nominal Rated kW kW Hour Energy WC Rise' Volume 51mge Input Input Rating Factor LP LP Volume Storage Input Input Rating Factor LP U.S Imp, Volume U.S. Imp. U.S. imp. Volume Liters! Liters! Gat, Gal. Gal. Gal. GPH GPH GPH GPH Liters Liters Liters Hour Nair RG134T6N' 30 25 29 27.000 27,000 46 0.54 29 24 29 24 RG1WMI 114 110 7.9 1.9 174 0.54 Ito 710 RG234T6N' 30 25 29 32,000 31,DO0 50 0.60 34 28 33 23 RG23076N' 114 110 9,4 9.1 227 0 60 1-79 125 RG230%R 30 25 29 3O,D00 26,000 49 0,54 32 37 32 27 NG23OS6N 114 110 8.0 1.6 186 0.54 121 121 RG14076N' 40 33 38 34,000 34.000 54 0.59 37 31 37 31 RG'4476N' 151 144 10.0 99 243 059 139 139 R024DT6N' 40 33 38 40,000 36,000 75 0.64 43 36 34 33 RG24u76N' 151 144 11.7 10.6 284 0.64 163 129 RG240S6N' 40 33 38 40.0D0 38.000 69 C,58 43 36 41 34 1`11324056N' 151 144 11.7 11.1 262 0.58 163 155 RG15OT6N' 50 42 47 34,D00 34,DOQ 75 0.83 37 31 37 31 RG150T6N' 189 178 10.0 9.9 2M 0.63 139 139 RG250T6N' 50 42 48 4C.000 36,000 51 0,63 43 36 41 34 RG250T6N' 189 182 11.7 10.6 307 0.63 163 155 RG25DL6N 48 40 47 40MO 38,000 77 0.63 43 36 41 34 RG250L&N 182 178 11.7 11.1 292 0.63 163 155 RG250S6N' 50 42 47 50000 48,000 75 C.63 54 45 52 45 RG25iiS6N' 189 178 14.7 141 284 0.63 204 197 Model A 8 C D E F G N J M S ApproL Number Floor Ito Jacket Vent floor to Floor to Floor to Floor to amm C!L of Water Gas Shipping Edmust Diu. &ft T&P Gas Top of Water Water Conn. Conn. Weight Gone. Conn. Conn. Neater Conn. Corm, NPT We in. In, in. irk in. in. In. I1. in. in. in. ft. RG130T6N' 591l4 16 3or4 49114 13 56'1, 57 191h 8 1h 1 106 RG230T6N' 59114 18 3 or 4 49111 13 5611. 57 211h 8 114 1h 116 RG230s6N 49rh 2D 3Dr4 301h 13 45N4 46% 23112 8 V4 1h 113 RG140T6N* 61111e IB 3or4 511/1 13 5713hs 5911% 211h 8 174 112 132 RG240Ti 6011111 20 3 or 4 491h 13 58511 571h 231h 8 114 % 134 011240S81,1' 51*s 22 3or4 4111.6 13 48V1s 48111he 25112 5 1/4 139 RG150T6N' 60111 20 3or4 4915he 13 56ye 57 Ili 23112 8 114 "h 148 RG250T6N' 60'h 22 3 or 4 49`:.E 13 56`h 571h 25112 6 1!4 !: 154 RG260LGN 51e116 24 3of4 401171a 13 411 Millie 271h 8 174 Vt 170 RG250S6N' 60'h 22 4 19 13 5611e 5711e 25'!2 8 167 Model A B C D E F 6 N J M S Approx. Ikrrlber floor to Jacket Vent Floor to Floorto PWto Floor to DeA Mof water Gas Shipping Ex haw Oia. WE T&P Gas Top a1 Water Water Conn. Conn. Weight Conn. Conn. Conn. Heater Conn, Conn. NPT size mm. mm. ITM mm. mm. mm. mm. rnlk mm. mm. mm, kg. RG130T6N' 1518 406 76 or102 1264 330 1429 1448 495 203 19 13 48 RG230T6N' 1519 457 76 or102 1264 330 1429 1448 546 2D3 19 13 53 RG23OS6N 1251 WE 76 or 102 987 330 1162 1181 597 203 19 13 51 RG14nT6N' 1557 457 76or102 1311 330 1468 1513 546 203 19 13 60 RG240T6N' 1527 508 76or102 1264 330 14M 1457 597 203 19 13 61 RG24055N' 1310 559 76orIU2 1043 330 1221 1240 648 203 19 13 63 RG150T6N' 1527 we 76 or 102 12M 330 1438 1457 597 203 19 13 67 RG250T6N' 1527 559 76or102 1268 330 1438 1457 648 203 19 13 lU RG250L6N 1310 610 760r102 1033 3M 1221 1240 699 203 19 13 77 RG25CS6N' 1527 559 1C2 1268 330 1438 1457 648 203 19 13 76 Propane models feature a Ttanium Stainless Steel propane burner.For Propane(LP)models change suffix"N"to"X For 10 year models,change suffix from"6"to 10". Based on manufacturer's rated recovery efficiency. -{C f- •Models feature optional top T&P location and must be specified when ordering. Note:RG230S6N and RG250L6N do not have top T&P option, Uniform Energy Factor and First Hour hating is based on the latest AHRI directory Itstings. General: Meets NAECA Requirements. optional Top T&P valve: All gas water heaters are certified at 300 PSI test pressure(2068 kPa)and 150 PSI working pressure(1034 kPa), All water connections are'/." NPT )19mm)on 6'(203mm)centers.All gas connections are'h'(13mm). J All models design-certified by CSA International {formerty AGAICGA) to ANSI standard Z21.10.1. M F D Dimensions and specifications subject to change without notice in H G accordance with our policy of continuous product improvement. G Suitable for Water(Potable)Heating and Space Heating. Toxic chemicals,such as those used for boiler treatment,shaft NEVER be M t introduced into this system.This unit may NEVER be connected to any 6 existing heating system or component(s)previously used with a non-potable E water heating appliance. - B 0 -BRADFORD WHITE 15- AMEERICAN Sales:800-523-2931 • Fan215-641-1612 STRONG- 2417 Technical Support:800-334-3393•Email techserv®6radfordwhite.com Products made by Bradford White are manufactured in the United States using the finest raw materials and components from around the world. Built to be the Best' 1101_G-0822 ©2022,Bradford White Corporation,USA.All rights reserved. Printed in U.S.A. n Ike a w N w o _ a e r o r... v Q � G1 V o � w �..t pry ►- o Av W z Gi C7 Q � o cii0n LLI w o z o , � V� _ zLL ca ui Cc) g EL 8 M 06 HeIi " z ai D � E mvi I Itss» cl u {V st.nf> tui C M t,' � L J t. 4w, `' me 14 as ti �•� �v� _ _ , Ali t A C^� DATE IMMfUDIi"YYY) f-1 �-! CERTIFICATE OF LIABILITY INSURANCE 10/9i2025 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 INSURFR(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy{ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Certificate Unit Edgewood Partners Insurance Center PHo 404-781-17{I4 �a NoI. 100 Montgomery Street Floor 20 Suite 2000 DADDAD Xss_ apexcerts@epicbrokers.com San Francisco CA 94104 INSUR1i AFFORDING COVERAGE NAIL• Licen 013129 7U INSURERA:AIU Insurance Company 19399 INSURED APEXSERI INSURERS:Upland Specialty Insurance Company 16988 1 00 Grasslands Road uni 8 Campisi, Plumbing, LLC INSURER C:National Union Fire Ins Co of Pittsburg19445 10 -- Elmsford. NY 10523 INSURER0: INSURER E: _ I INSURER F: COVERAGES CERTIFICATE NUMBER:1615477053 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. INSSR ADOL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSIJ POLICY NUMBER MMID MMfO LIMITS R X COMMERCIAL GENERAL LIABanY Y USPCL0284125 8/1012025 8/10/2026 EACH OCCURRENCE S 2.000,000 CLAIMS-MADE XOCCUR ED PREMISES a occurrence $100,000 MED EXP(Any one person) $Excluded PERSONAL 8 ADV INJURY $1,000,000 Gli AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $4,000,000 POLICY l JECTPRO- LOC PRODUCTS-COMPIOP AGG S 4,000,000 X PRO- OTHER S C AUTOMOBILE LIABILITY Y 9812741(ADS) 41112025 $/111026 COMBINED SINGLE LIM S5,0oD,0W Fal accident X ANY AUTO BODILY INJURY(Per person) $ OWNED F SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE : AUTOS ONLY AUTOS ONLY Per t $ B UMBRELLA LIAR X OCCUR Y USXGL0100925 8/10/2025 8/10/2026 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS MADE I AGGREGATE 54,000,000 C7 RETENTIONS S A WORKERS COMPENSATION 020396018 IAOS) 4/1/2026 4/112026 X I WR STATUTE ERH- A AND EMPLOYERS'LIAR ILITY Y f N 020396020(WI) 4/1/2025 4/112026 ANYPROPRIETOR,PARTN EFU EXECUTIVE E.L.EACH ACCIDENT $1,000,000 iOFFICERIMEMBEREXCLUDED' M NIA IMandafbry in Ni E:L.DISEASE-EA EMPLOYEE $1.000.000 h yes.,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000.000 DESCRIPTION OF OPERATIONS f LOCATIONS/VEHICLES (ACORD tut,Additional Remarks Schedule,maybe anached it more spate is required) Village of Rye Brook,to the extent required by written contract,is an additional insured with respect to general liability and auto liability.Umbrella is follow form over the General Liability,Auto Liability and Employers Liability. 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 938 King St. AUTHOR2ED REPRESENTATIVE Rye Brook NY 10573 f O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2011 103} The ACORD name and logo are registered marks of ACORD Workers' YORIc CERTIFICATE OF STATE Compensation Board NYS WORKERS' COMPENSATION INSURANCE COVERAGE. la.Legal Name&Address of Insured(use street address only) 1b.Business Telephone Number of insured 914-946-5558 rani&Campisi plumbing.LLC 100 Grasslands Rd Ste130 1c.NYS Unemployment Insurance Employer Registration Number of Elmsford.NY 10523 Insured 8831360264 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 92-0299696 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) AIU Ins Co. Village of Rye Brook 3b.,Policy Number of Entity Listed in Box"1a" 938 King St, Rye Brook, NY 10573 020396018 3c.Policy effective period 0410112025 to 04/0112026 3d.The Proprietor,Partners or Executive Officers are �X included.(Only check box if all pariners/of5cers included) all excluded or certain partnerstofficers excluded. This certifies that the insurance carrier indicated above in box 7'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 D to n Bailey 7 i�5 ne o onzed representative or licensed agent of insurance tamer) Approved by: 05/12/2025 {Signs ure) (Date} Title: CEO, North America Telephone Number of authorized representative or licensed agent of insurance carrier 212-770-7000 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) ww v.wcb.ny.gov