LAA Application Details

NYC Department of Buildings

Premises: 69 CLARK LANE STATEN ISLAND
BIN: 5101370 Block: 579 Lot: 231			LAA #: 520170671

Documents Collected | Plumbing Insp | Payment History | Virtual Job Folder

Printable (PDF) version of Permit

DOB NOW: Inspections

Last Action: SIGNED-OFF BY MBW - 03/22/2016 (I)


	Pre-Filed:	03/17/2016	Approved:	03/21/2016 1:18 PM	Expiration:	03/21/2017
					Electronically Filed:	No
Work Description


Location Information (Filed At)
House No(s):	69	Street Name:	CLARK LANE
Borough:	STATEN ISLAND	Block:	579	Lot:	231	BIN:	5101370	CB No:	501
Work on Floor(s):	BAS


Fee Assessment
Fee Structure:	STANDARD
Estimated Cost:	Category 2 - Estimated Cost of Unlimited Work $1,800.00

Additional Information
Building Characteristics:	1, 2, or 3 Family
Legalization:	No


Applicant Information
Name:	ROBERT BERNARDO
Business Name:	R B MECHANICAL, LLC	Business Phone:	718-727-0803
Business Address:	150 LYNHURST AVENUE, STATEN ISLAND, NY 10305
License Type:	MASTER PLUMBER
License Number:	001169
Applicant Insured By:	UTICA FIRST INSURANCE CO	Insurance Expires:	08/03/2016


Work Detail
Plumbing: Category 2 GAS PLUMBING WORK Gas Authorization Required
Proposed Work Summary:
	REPLACE DEFECTIVE GAS FIRED WATER HEATER. TO INSTALL RHEEM 40 GALLON WATER HEATER GAS FIRED DIRECT REPLACEMENT GAS TO GAS TO VENT INTO EXISTING CHIMNEY IN PROPER WORKING ORDER MODEL RHM22V40S, 40,000 BTU CSA#2901-85. 0315/6HPDGREG


Additional Gas Information
Meters: 1 OSP
Risers: 1 BASEMENT
Gas Uses: Water Heater

Appliance Data

Total Number of Appliance(s)	Floor Location of Appliance	Item-Manufacturer Name	Listing Agency Name and ID #	Model Number	Input (BTUs/hr)
1	BAS	RHEEM	CSA#2901-85	RHM22V40S	40000


Asbestos Abatement Compliance

	The scope of work does not require related asbestos abatement as defined in the regulations of the NYC DEP.
	ACP5 DEP Control # 5230812 CAI # 123050

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