2012-213
2012-213
Resolution Approving New York Certified Electrical Inspectors, LLC as an Approved
Electrical Inspector for the Town of Wappinger
At a regular meeting of the Town Board of the Town of Wappinger, Dutchess County,
New York, held at Town Hall, 20 Middlebush Road, Wappingers Falls, New York, on August
13,2012.
The meeting was called to order by Barbara Gutzler, Supervisor, and upon roll being
called, the following were present:
PRESENT: Supervisor
Councilmembers
Barbara Gutzler
William H. Beale (Arrived at 7:31PM)
Vincent F. Bettina (Arrived at 7:47 PM)
Ismay Czarniecki
Michael Kuzmicz
ABSENT:
The following Resolution was introduced by Councilman Bettina and seconded by
Councilwoman Czarniecki.
WHEREAS, Chapter 114 of the Town Code of the Town of Wappinger requires all
electrical installations to be in conformity with the National Electrical Code and the New York
State Uniform Code; and
WHEREAS, Section 114-4. permits the Town Board to authorize and approve qualified
electrical inspection agencies to make inspections, re-inspections, and to approve or disapprove
any electrical installations within the Town of Wappinger to insure compliance with the National
Electrical Code and the New York State Uniform Code; and
WHEREAS, Jerry Caliendo and John C. Metsger are certified electrical inspectors in the
State of New York; and
WHEREAS, Jerry Caliendo and John C. Metsger are senior electrical inspectors for New
York Certified Electrical Inspectors, LLC; and
WHEREAS, New York Certified Electrical Inspectors, LLC, has requested to be an
approved electrical inspection agency for the Town of Wappinger; and
WHEREAS, Salvatore Morello III, Code Enforcement Officer for the Town of
Wappinger has reviewed the qualifications of Jerry Caliendo and John C. Metsger in their
capacity as senior electrical inspectors of New York Certified Electrical Inspectors, LLC, to act
as electrical inspectors for the Town of Wappinger and said Salvatore Morello III has determined
that the aforesaid organization meets all criteria required by the National Electrical Code to
qualify as an electrical inspection agency and recommends that New York Certified Electrical
Inspectors, LLC be approved as an electrical inspection agency for the Town of Wappinger for
all electrical installations within the Town of Wappinger to insure compliance with the National
Electrical Code and the New York State Uniform Code.
NOW, THEREFORE, BE IT RESOLVED, as follows:
1. The recitations above set forth are incorporated in this Resolution as if fully set
forth and adopted herein.
2. New York Certified Electrical Inspectors, LLC, through its senior electrical
inspectors Jerry Caliendo and John C. Metsger is hereby approved to be a
qualified electrical inspector for the Town of Wappinger and is hereby authorized
to provide ministerial electrical inspection services for all electrical installations
within the Town of Wappinger to insure compliance with the National Electrical
Code and the New York State Uniform Code.
3. New York Certified Electrical Inspectors, LLC is further appointed as an agent of
the Town of Wappinger to make electrical inspections and any necessary re-
inspections of all electrical installations made in the Town of Wappinger, in
accordance with Chapter 114 of the Code of the Town of Wappinger, provided it
maintains the required liability insurance naming the Town of Wappinger as a
certificate holder thereof.
The foregoing was put to a vote which resulted as follows:
BARBARA GUTZLER, SUPERVISOR
WILLIAM H. BEALE, COUNCILMAN
VINCENT F. BETTINA, COUNCILMAN
ISMA Y CZARNIECKI, COUNCIL WOMAN
MICHAEL KUZMICZ, COUNCILMAN
Voting:
Voting:
Voting:
Voting:
Voting:
AYE
AYE
AYE
AYE
AYE
Dated: Wappingers Falls, New York
8/13/2012
The Resolution is hereby duly declared adopted.
C~u(1LLfo~
CHRISTINE FULTON, TOWN CLERK
CLERICAL ASSISTANT
Michelle Gale - Ex! 123
TOWN OF WAPPINGER
FIRE INSPECTOR
Mark Liebermann - Ex! 127
TOWN SUPERVISOR
Barbara Gutzler
ZONING ADMINISTRATOR
Barbara Roberti - Ex! 128
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Michael Kuzmicz
CODEENFORCEMENTOFRCER
Salvatore A. Morello III - Ex! 142
Susan Dao - Ex! 126
PLANNING BOARD &
ZONING BOARD OF APPEALS
SECRETARY
Sue Rose- Ex! 122
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
PH: 845-297-6256
Fax: 845-297-0579
www.townofwappinger.us
Date: July 23,2012
To: Barbara Gutzler / Town Supervisor
CC: Town Board Members ~
From: Salvatore Morello III / CEO~'
Re: Request to add Electrical Inspection Agency
New York Certified Electrical Inspectors, LLC has requested to join our list of approved
inspectors to perform electrical inspections in the Town Of Wappinger. As with any new
electrical inspection agency wanting to come into the town, I informed them approval must be
given by the Town Supervisor and the Town Board.
There are two inspectors in the agency requesting approval. I have gone through their
certifications, training and approval from Central Hudson for a reconnect and disconnect from
an electrical grid and feel they have all the qualifications to perform electrical inspections.
Copies of their credentials are attached.
Jerry Caliendo nybei1 @Iive.cc
845-294-7695 Office 7-8 PM
New York Certified Electricallnspect<
Orange Co. Division
203 Purgatory Road
Campbell Hall New York 10916
845-339-2119 J.C. Metsger
NEW YORK CERTIFIED ELECTRICAL INSPECTORS
LLC.
203 Purgatory Road
Campbell Hall, New York 10916
196 Binnewater Road
Kingston, New York 12401
REQUEST FOR ELECTRICAL INSPECTION ACCREDITATION
Dear Sir or Madam:
John C. Metsger and Jerry Caliendo, Senior Electrical Inspectors,
request to be added to your list of Approved Inspectors. We submit
the following Information for your review and approval.
Mr. Jerry Caliendo
845-294-7695
Summary of Qualifications
. Senior Electrical Inspector for the New York Board of Fire
Underwriters, 1993 to present.
. New York State Building Code Official NY0003527
. National Certification Program for Construction Code Inspectors
. Electrical Inspector (One and Two Family Dwellings, General and
Pia n Review)
. Updates to NEC 2002 and 2005.
. Master Electricians License (shelved)
. Member City of Middletown Electricians License Board
Mr. John C. Metsger
845-339-2119
Summary of Qualifications
· Senior Electrical Inspector for the New York Board of Fire
Underwriters, 2002 to present.
· New York State Building Code Official NY0007782
· National Certification Program for Construction Code Inspectors
· Electrical Inspector (One and Two Family Dwellings, General and
Pia n Review)
. Updates to NEC 2002 and 2005.
. Master Electricians License (shelved)
. Member City of Newburgh Electricians License Board
New York Board of Electrical Inspectors LLC
Page 1 ot2
New York Certified Electrical Inspectors LLC.
203 Purgatory Road
Campbell Hall, NY 10916
Click here for the "Application for Inspection" fOr"01.
Our Inspectors:
Mr. Jerry Caliendo
Office: (845) 294-7695
Fax: (845) 294-0026
(Orange and Rockland County)
Qualifications
. Senior Electrical Inspector for the New York Board of
Fire Underwriters, 17 years.
· New York State Building Code Official NY0003527
. National Certification Program for Construction Code
Inspectors.
Certified Electrical Inspector (One and Two Family
Dwellings, General and Plan Review)
· Master Electrician License (shelved)
· Member Orange County Electricians License Board
· Member City of Middletown Electricians License
Board
Mr. John C. Metsger
Office: (845) 339-2119
Fax: (845) 802-0017
(Ulster County)
Qualifications
· Senior Electrical Inspector for the New York Board of
Fire Underwriters, 8 years.
· New York State Building Code Official NY0007782
· National Certification Program for Construction Code
Inspectors.
Certified Electrical Inspector (One and Two Family
Dwellings, General and Plan Review)
· Updates to NEC 2002 and 2005.
· Master Electricians License (shelved)
http://nycelielinsp . com!
2/11/2012
Page: 002
~
NEWYORK-05
GYONNETTI
ACORCY CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDlYYYY)
~ 7/2/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA TlVEL Y 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 pollcy(les) must be endorsed. If SUBROGA TlON IS WAIVED, subject to
the terms and conditions of the polley, 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 License # PC-11 03659 ' ~~~~ACT Gall Yonnettl x3950
Ulster Insurance Services, Inc, I WgNJo Ext) (845) 338-6000 I r1\~. No) (845) 331..0006
PO Box 3995 -- .--
Kingston, NY 12402 ~D~~~SS
INSURER(S) AFFORDING COVERAGE NAIC. ~
INSURER A . Merchants Mutual Ins Co 23329
~. -~
INSURED INSURER B :
New York Certified Electrical Inspectors LLC INSURER C : .-.---
203 Purgatory Road INSURER 0 :
Campbell Hall, NY 10916 INSURER E:
I 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 I
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTOWHICHTHIS
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.
II~f~ TYPE OF INSURANCE INSR WVD POLICY NUMBER I fMM/DDIYYYYI 1~~T6~M~\ LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
~
A ~ 5MMERCIAL GENERAL LIABILITY BOPI041874 7/21/2011 7/21/2012 ~~~~:S~S lEa occurrencel $ 500,000
'-- CLAIMS-MADE 00 C"='=UR MED EXP (Anyone person) $ 15,000
PERSONAL ,~ ADV INJURY $ 2,000,000
GENERAL AGGREGATE $ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PR0DUCTS - COMP/OP AGG $ 4,000,000
I nPRO- n $
POLICY JECT LOC
AUTOMOBILE LIABILITY :=g~~~~~~~nSINGLE LIMIT $ 1,000,000
-
A ANY AUTO BOPI041874 7/2112011 7121/2012 BODILY INJURY (Per person) $
- ALL OWN ED - SCHEDULED
BODILY INJURY (Per aCCIdent) $
- AUT0S f--- AUTOS
~ ~ NON-OWIIED FJ;,~~~c7d~~tT)AMAGE $
HIREC' AUTOS AUTOS
$
~ UMBRELLA L1AB ~ OCCUR EACH OCCURRENCE $ 4,000,000
A EXCESS L1AB CLAIMS.MADE CUP9141186 7/21/2011 7/21/2012 AGGREGATE $ 4,000,000
OED I X I RETENTION $ 10,000 $
WORKERS COMPENSATION 1r~~n~Ws I [OTH-
AND EMPLOYERS' LIABILITY ER
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A E LEACH ACCIDEm $
OFFI CER/MEMBER EXCLUDED?
(Mandatory In NH) EL DISEASE. EA EMPLOYEE $
~,~~~::~(~ir~~ ~n~2{PERA TIONS below E L DISEASE. POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more .pace is required)
Proof of Insurance
CERTIFICATE HOLDER
Town of Wappinger
20 Mlddlebush Road
Wapplngers Falls, NY 12590
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOREr I
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
~/lJ~
I
@1988-2010ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2010/05)
International Association ot Electrical Inspectors
Thl~~~fil~~rtI\Y',~
G~ldrJ',CaHen~
~ /;.~.. 0
Has met the certiflca~n reqctlrtlru~..nfS as e~b\IShed by IAE\ for
ELECTRICAL INSPEC10R-ONE:'& TWQ;FAMIL Y DWELLING
('(' ,.. """" "'<;:,
Certification H 8372f?/CAl IHS'?\-" Expires 9/30/2014
~-/~
\AE\ Secrelary \0 Ihe lnlernatlOoal Board 01 OlreclOfS
International Association of Electrical Inspectors
T~~:rl~~~ltl~J~
GE3'Bld'J':Cal,endo
::: ./~.:'t:>..,. _ -0
Has met the certitica@n reqdrr.e'1}~nfS as e~blished by IAEI for
ELECTR'~ INSpeCTOR"GENERAL
{'l: ,..,,,,,," . .",<;:"
Certltlcalion H: 83723 0'/CAL \\'IS'?\-'V Expires 9/30/2014
s=?~~
IAE\ Secrelary to the lnternallonal Board 01 Directors
International Association of Electrical Inspectors
Th$(~t~~lerfi"l,lb~
Gej'8ld\:I':Caliemto
~ ,_''':-'- /
Has met the certifica~n reqdrf~m~tlts as e~blished by IAEllor
ELECTRICAI2)t!SPEa6R-p~~N REVIEW
('. .,,,..,.,,,, .<)
, ,,"'0' ,,"
Certification H 83723 /C,II I~\~S~ Expires 9/30/2014
~-/~
IAJ::1 ~f.nAlary If, the lnlernallonal Board 01 Oil9clofS
r'
.J
..~rt!H::';:;'I~~ ::)i!'~'; ~J ... \: ;:;:DJ~::'G0i1, '"Jffi:0:' -:--;i~:"':1!\~~\,;.;';; :l~;,~' :: 'r.;~:: !J!r.:;~' :;;~:;.:r: '.WIJ~~:J ~~'~:.::.;J:.y,,::,:;.;; ~ '(' ,.0'i~\~~n~iilij:r;~~;:\.~.liI' -;; '~~~;,.
",la, "l""~' ',.~ ~ u..l".J(,;~, ~_j,.'~'~' ,1'S" 'k,w ....\ .'~)A~',:-' ~'I,',\\,'''' ,{. ,,' I. . 'I~" ..\.t "l'l"'~"""" ilk >0..,.... ~.}... <..ut.!..J.~\., :so ,III,' \ ,.r J>'J_t I' l!i.> .'10'" ,,.., ,-~~: -.' 'I,"',,>' ',.~t\,I"uu" h .~.
--........_ '. "II ' .~. :\\ t ""'~.'''.4~' I ,,""-oj ........... '"'' IIo' ,{; ,........" _r-Il' , .~. '..,'. ,. ~"..' . ,......'t ..11~'. '~', · ......,.... ~~
,.....Ii .1...>' ...-:,i. .~c? '11"\\\ ,lo . ........"'..;."I'I~ "U'~\\\'v' ~''"'''''' :_I~" ~I ' ...)......."."...... ..>: ...<>;..I"'l"'hll.,ltll;~l\' I J~'~ -,,'!.'''' J.~. .~. ,oS"--,,,,';:.' IL.. \ ,',/J'"!.\ ""' ('~..'.l~"'_ ...
_ _~_.. ",' " ';1 ... ~. I ~.-.... I 11,' ~ 'jr:;. ' ~...... t l~!.-~ ......n~"" '1===;,\' ~,- ............... - -... \\'UU' ~ I ", j ['- "
. _.;,-'" """" .._<~",_"",,'" i'l "'~"" ". ." ,,,,,.1;- ,-",;-" '\"1.':-;~' ''','-....--..,.,.. <''f.'-''':!> ",'n' ~.
~/i;~2j"\ !~":f;'-i.'.~"~. -W!-\:<<"\!.....: .>';;:"'. f.?:.>i: " <jr.'i.' _~l!I!'~~J.fK',. :"I" .~!~1"i'.;:;,.l#';..~"'I,.-\.F'''.c'..:'f -.'.!;f\~.,~;'II'7',-);
'{/fi.~if .. ..11; "~! ~ ':\~ .. PI'D'I '. .. Jl:-~ " .' .~,,~., ~ ~ ~f?'~-~' ~-;sf>O:f, ,(1'" -,'0 ;.... v.o. :".'\ ,,~~~ /.7e,.,_ ,;;If - ',}; " ," ~;o ~.. /f./
~:..,~.:.,.J~..;~....:.;;;,~.:...":...':.- '..:,'::.:-::-":.'-: 'A""_-":"~'_:''\.~'~!:~':'''': l'.~: ' . ,.;.-);-' .',' .3>' \I"';;'~; ;.~._~.. '
\
I
.1
;.!i
11
'I
ii
,I
. ,'*ll~;i
, _.r"I~~'
: ::t:~~~~:!LY~i'~"~<!
':.;~:!:ft.
~/
\........
", ""-
',--- '"
~A.... ..
~""".......
J N~':
;- ~ ~~
:: '" ~\\
....:..:..c:.-
-.........
-~
'-
.?
r.
-c I
~ ~,,\c ~"'-.
-2 ..... r :::
"~ :.. i'~,,-.'
'~
z. -,
~
-.
..,)
~ / \1~, ~ ~.:, .~'.("
~ \!,.-',.~-"'~
\ ~ . "'afr _'
~ ~ -~ ~.
~ . ~~~
~ i' r".:J
i ~: i .:
\ _.
-..,
::::
::::.
!JI
,
-I
,.J
'J'
.~
-'"
::
.t;'I!:GC1~C.",
. . . :'~ (,\ * , :. .. . <
v" --4(~- 1 j c.
... ;} --4 ~''- f / \
. ~,/ .J ~_ ~ ",-(. .
:' 5( ::" -' , Do \) () "0.
o .c., I" I ""l'1'
~ ~ .
. l~\ ~-~ .
o ~ \ /..
o . hi 0
,...r. I ~:
'. '1'\, fi... . / . :
o ^ /. f ,,,_ ~ T-- :
..' /'f-l~l' .'
. e 0 - ~ ....j\ l'I . G
."6C;"'.G"Q'" (,
'.........: Q
(~<.\
-'
<"",
"
...._~.....
-..,
.-- .
-....,-
~l:
~
,-...
......
-..
("'-.,
"
........
:..-:
<"'.
"......
~
~
"'"
'-......:
......
r-;
~l
~
'"
:o:........~
c/)
-
r""",
L....-'"
--
"-J
,.....
............
.-...
~
.......,..
("'--..'
""--
~:
--",''1
'-
--
,
~~
ktj
,-
--...'
......
,
--..,...
........
'-.d
~
......
f-."",,,
"
f........"
FJ
,,,",
-..,.;
r-.
~
("'"
"
r.....
,~
,'"",
v \,
-...
-.,
-.,.
......
......
'-..;
""<~
i""-'
llj
'"""'
'......
'--..,.
,--.
'" -
........
",--;
---+-.
.--."
............
,~
--
('""""....\
...........'
r,
~
~
......
("I-..
....
."....
~
...,:~
....,.
"""
~
~.o;i
-...
-
~
~.
......
~
,.....,
--
~"""-l
'''''"''.....
~...J
.~
""
.....
r
,,/,
"-\'
......,
~.....
-~
'"-
,....,
'-'
'-.;:e>I
~j
'--~
'--....
,-,
.....,.,
.
!",--,
'"
'J"":
r-.
.......
.
-
,-..,....
'~
to
r--..
--
"""'...,:.1
('~
I~
V
......
--
--
<""t
"""
-.,
~.
1..:..:..:_
tJ
(~
--
....':
("'......
.....)
~
......
--
-'
<\:
---""'-.I
-
"-t.
~.
'-"
~
V'j
--'-;,
~
~~
"-I-
r-~I
,'"'
, '..J
...~
~J
-..........
~
.......
-...
'"
-...,..
......
--
'--...
'-'
"--..
i'\)
"'""I-
~
.........
~~
.....~
--..J
..,-'
c/]
~
r-"
""-+-
--..
,....,
""<-
-:.
..L,
f
-".I
--k..
(:1'\
(",
'-<.Y
-}...
--.,..
"".
"-l
......
~
~
......
.....
--
("~
,':'
.......
~
(",
'"
~
~~
--k.
U.,j
-k
/""-.,
-....,;
.~
~-r-
-
~
,.......
....
~,
~
-
-
1:._J
.......
"-
...."
,,:,-.
~,
-.
......
.......
...,;,
l~
..),)
t'"
....
,"'-> "
"'i'
~
""""
-.;.
"""
'-
-
---
i-""';
-r
--
.......,
~
F~':1
""',~
.-..
-
C/:)
-...
,-.
/.....
( I
"~>l ...:
("',
, .1
'"
'--'
t'.
--
~.
~
.....,
/""
,-
...-'''.
',-,'
L:N
j
--
,
--..~
-...
(.......
,;;-'
l ... .;
z
......
-.....;
r-.
'o.d
-
~
,..<
"'-'
(~
""
----
-..
......
.......
r:J;:;,
~~
--..
r:--...
~
~
:r:
-.
~
r-
("",
r-..
"
:..:
. c:......~
-.,..,
~\ ..
.......
~
--
.,-J
r~
\.;:1
...~
,........
,~
'J~
--
~
~
...".
.....'
.....
~:r'" ~
g;:.
p
:.,~,
..-
-..
I ,
(J
-
-=,,'
J==.4
,->>'
~TJ
~
Z
".=-..;;..l
~
,~
;;;0
(~
rr;
':.;;;-
~"
~
L --'-j
Z
0=5
p=:;
A:
",
~
t......
Z,
i"='
'Z
r<""
... "
('=j
",....,
...-........,j
~
" :..,~c?~.: .."~~
':-i,.- "
..... 'iii.. . :.\" -:
,/.~1..~.,
I~i~t":~,\s'~)
\
; ) 1 ~ , " I ~ >j .;,
tll
..",.!./ ~
<=j
>
~
J
rr:
.. J
n
....v
1J
Z
m
<
.~
j
I~
'"
o
10
"T(
rf'-;
~
.....'
'"'~
1=<-1
!~
~~
~
~l
l.......j
" ;_ Ii .0 " ~ " '" [,
pj;"':t~;:\ll_ ..,,'j,....~
.'~~-.., .~...I).c".
0' ._~~,' ~i ~ -;;." 1. ,.
,,;. ..;."~"I:';."'1'.',,,",'W'~~: . ::. \
. ~;.:, .ilHiJA _ I _ .'"
: ;.:.. \ ~ ~ f? ' .,; 7.:
: ~ .;<..~~_~~ ' ,~G
~..J - :~- --,~."",:} ":""" ~
'J /.. \... ,,~~ c .'
'.).. . S<,...", ~j -)~ 0
""-_._-""'" -a. L .'
'" ,'j ['F ,\ .'
o ~, c c, : 40 '" (' < " ., <'
:i~:k~
,'~~~~}.~
.,r:::-~~;~
i _ '.!In.;:!riJ.
I \'f;t~~~}
.;I(lMI
.'.~lrj:
:,(/'{_:~t,!.~!
~':Y:llw
,ifg~
I;'~~~
i~~~\
.:~~:~
';":1fJ!'
~ ..,.. .
..;i~~
:... ,(
Certificate of Attestation of Exemption
From New York State Workers' Compensation
and/or Disability Benefits Insurance Coverage
**Thi.\Jorm ('{/fIIIO( he IIsed ((I wai\'c (he work.ers' compefl.\Il(ioll riJ.:h(.\ or ohliJ.:arioll.\ of allY parr\" **
Ilk' applicant ma: Lhl' 1111, l ertllicilk ut ;\tte,tatilH1 ut', \emption ONLY Il) "l1u\\ d ~ll\LTl1llleJll elllil: that "-Jt.:\\ Yor~ SLlll'
,peltlil \\ llr~t.:r,,' l'umpcn~allun al1d <1r dhabilll\ hl'netits il1SllranCl' is nul rt.:ljlllrcd. Il1l' ~Ippllcant ma} iIojOT use Ihl, IUrI])
tll ,hu\\ ~111ll1her hUSlnl'S~ llr that hu~inL''''' 111~ur,lI11l' carrier that ~ulh 111~Ural1le is not reljuirt.:d.
Pleasl' pro\idl' this form to the gmernlllt.'nt entit~ frolll whirh ,uulIn' requesting II permit. license or contrllct, This Certificate \\il
notlH' arl'eptl'<1 h~ gO\ernment officials one ~ear lifter the (hlte printed on tl1(' form,
In the Appliclltion of l Business Applying For:
(I.egal Entity NanH' and Address): () IIII\{: \\ ()\{"\I\ \S (()\tI'E\S\II()'\ L\I-\ll'll()\
'q\\ 'llW'" (fWllflUlfl U IHI( \1 I........'.U I (IH....III
IlII \. 'q \\ 'llH" ( fH III If I) I If ( I flll \ I "'....>f (I ()H....
21U 1'1 H(, \ I llH' Hll\1l
( \ "PIH II f1\ 1 I, ...., I II') It,
1"" "" ,,,,.,, .,." fI" \\ \ \\" ."
I'rum: '\1\\ '()I~" SI\ n
Workers' (ompenslltion Exemption Stllternent:
Ihl' ahll\l' named bmJf1ess IS lertlt~ Ing that IllS ~()T RH)l'IRED TO OBTAI''\EW YORK STATE SPECIFIC
WOR"FRS' (O'1PF~SATIO'" I'\SI R.\WF CO\ FRAGE for thl' folluwlng rl'a'ol\J1
I hc hllSlnl'S' IS II I L.I lIP. Pili> ur it 1\1.11'. (}R I, a partnership lInder thl' lalls ul'\;l'Il Yllrk Statc and is nOI a cllrporallun. Other
than lhl' partnl'rs ur I11l'l11hl'rs. therc arc no I'l1lplll\l'es. da~ labllr. leased employec~, borrowed l'tnplo~ ecs, part-timl' L'l11plu} ee,>. unpaid
I llilll1!L','rs (InL'luJlng ramil~ Illl'l1l0erS I ur ,1IbC(lnll'alturs
I'Hrlnen!\lemhen: HlIl....l \111....101 I{
Disahilit) Benefits !::\elllption Statement:
I hI.' ablllc named bllslncss IS lcnll' In~ that It IS "en REQllRED TO OBTAI'\ "IE" YORK STATE ST..\TlTOR'
DISABILITY BE'EFITS I....Sl RA'iCF CO\ER.\(;F tor thl' follO\\lng rcason
Ihl'husllless\ll SI bel'llhl'r I) ,l\\nl'db\ onl'lndl\ldual: l)R.:'1 isapartnl'rshlp(includingLIC, lIP, PLLP, RLLP.mLP)ulldcr
the lil\IS ot'-C\\ lurf.. State and I'> nut it cllrporatilln. lll{ .1) IS a (lIle llr IIILl pers,ll1,lwnec1lorporati,)n. \11th those If1JI\idllals ll\\I11ng
all'l!' the stUl'f.. <lnd twldin~ all utliccs l,f the ll1l'poratioll (Ill il (\Ill persoll (III nl'd lllrpnratllln eal'h Indl\ Idual must hc an l)tYill'r and llll 11
at Ieasl one sharl' llf SIOC~): (}R 4) IS a hll,iness II Ilh IW \YS Illl'<ltioll In <lddiliun, the bUSlncs'o does Illl! require disability henl'fits
L'll\ L'r<lgt: <II thi, timt' 'IIH:L' II has Ill)t l'mplu)ed ,JIll' \lr nhln: Indil Iduals UIl at il'ast -,U days III <ln~ calt:ndar year In .....ell lorf.. Slale
(Indepenlknl L',1I1tractors are rwt Llllhldered tu be Cll1plll) ccs under lhc Di~abilil~ Benefits l.aw )
"~----_._----------_._-_._--~--_._------
l,j I{.\lll J (.\111.....1)( I. :1111 Ihc I':lrlIIL" ,11th Ihl' dl){lIC-lliIl11cd kgal CIlIII\ I anirl11lhal dllc III 111) !)(hrllun Illth Ihe abOll'-named hllslnc" IILII,' Ihl'
,1111\1 kd~c'. I/\hmllallllll ;111.1 aullll,rlll 1<' 111:11--L' 1111, I ertl!'lc;tlL' III' '\l1e,!alllll1 111'1. \emplllln IlIcrdll ;11'1"11111 thai Ihe ~1;llcll1eI11S made hcrem :lfL' I rill' Ih,ll
lal L' Illlllll,ldc' ;1I1~ l11alc'fl,1Ih IdhL' ,lalc'IIlClll, :\fld I 11Iakc Ihl' l crlll'leall' lll.'\lle,lalllllllll'l \L'lI1pIIUIl 1I1ldCf thL' pCI\altln III ['l'f.lllf\ I lunhcr ,111"11111 111.11
Ulldl'r,lal\d Ih:ll ,Ill) ral,c' ,Llll'l1\l'lll. rl'!'rL"L'Il\;\lllllllII l'llIICL'alll1c'1l1 II ill '1II'll'l'l mL' hI kllll1\ L'rlll1lllal Pfll'L'cullllll. l/\cludlll~lall and ell 1IIt;lhrllll 111
IL"HlLtII"l' \l IlhlhL' \\ IlrkL'f" l 11l1l1X:lh,l1lllfll :111 :\11.1 ,1IIllihL'r .....l.11 Y"rk Slall' lall' 1\\ 'lIhllllltlll~ 1111' (L'rtlliC;I1L' III .'\llnlallullllll \L'lllpllllll III IIIL'
!lllc'lllIlll'lll l'/\III\ 11,IL'd ahllle I :1I,"hl'fdll dlflrrll 111,11 ,fL'lfellll1,laIlCL" L'hall~L' "I thai Ilurker,' L'UII1I1<:lhallo/\ Illsurance' afld Of d"ahilll~ l1<:nL'111S
uIl'r:l~l' I' fL'lllllrcd. Ihe :lh\lll',n:lI11ed k~al CllIrll II III II1IIll,'diatcl\ anjl1lre appropriate ....L'II lurf.. Sl:lte 'l1<:cil"ll' IllHf..ers' cUlllpensallUI1 In~lIr:\ncL' :'Ihl "I
1":lhllll\ t,,:nL'f11S L'UIl'f;\~l' ;lllll :11,,1 1111l11l'dl:llL'l\ 11IrI1l,h pr(\Ulll! Ihat C(llcril~l' un fllrl1h appfllle'd hI Ihl' Chair llllhe \\ url--crs' I L1mpelh;I1IUI) I\ll,lrd III
hl' ~llIC'lflllll'III"ll1ll\ Ilslnl ;lhol,'
')('1'; I (/1 /i /
~EJHE Signature: ~,Jd~ t~~,~r'
Excrnption.~Ccrtifi~atc !'Ii urn tlr/ :. -:;J'
20fl~9~86 1 t~~~i r
Date: /~ II: cJt1//
c::;;: Rece i~d
, ' . ,
~v~ \U~~,~rf!J91~"~.~,~ n.......
Hereby Certifies
John C. Metsger
To hdve been duly registered, hdving demonstrdted proresslondl
qUdllhcdtlOns by pdSSlng d written eXdmlndtlon estdbllshed by
the BOdrd of Governors of the Ndtlondl Certlhcdtlon Progrdm
for Construction Code Inspectors In the module of
Electrical Inspector; General
dt the tXdmlndtlon held on
October 2, 2002
In wllneB thereof th,\ certlflcdte hdS bf:f:n I~~ued thl~
Twenty Fifth day of August 2006
r
~/~
:,A[ ~__"~(,jrIYt' )11t'C!01
, . . . .
~ir.a~~,
05119/2012 08.
13;jfif: la~<
.---'
i1''tb.:l::l r-
. vv I(VVO
~ ;:J~
1-
.pk
U~/l~/~Ol~ U~:lq tlq~ ~~q(b~~
L
ji'lbj::l r. UUi/UUb
Contract No. 25332
;
ELECTRICAL INSPECTION AGENCY AGREEMENT
TIllS AGREEMENT is made and entered into this ~ day of Augus t 20~ by
CENTRAL HUDSON GAS & ELECTRIC CORPORATION (hereinafter referred to as "Central Hudson"),
which is a New York Corporation engaged in the business of distributing electricity and which maintains its
principal place of business at 284 South Avenue, City of Poughkeepsie, County of Dutchess, State of New York,
12601, and by New York Certified Electrical Inspectors LLC (hereinafter referred to as "Agency") whose
place of business is located at:
203 Purgatory Road
Campbell Hall, New York 10916
FIRST: The Agency desires to perform electrical service inspections on certain dwellings within
Central. Hudson's service territory; and
SECOND: Central Hudson is willing to permit the Agency to conduct such inspections.
NOW THEREFORE, in consideration of the mutual covenants contained herein and intending to
be legally bound hereby, the parties hereto agree as follows:
(1) The Agency agrees that it will promptly comply with each and every requirement set forth
in the "Central Hudson Gas & EleCtric Corporation Requirements for an Electrical
Inspection Agency" attached hereto as Appendix "A".
(2) The Agency agrees not to assign the Agreement without the prior written consent of
Central Hudson.
(3) The Agency agrees to hold Central Hudson harmless and indemnify Central Hudson in
connection with any damages or il\i'U1)' affecting any party, resulting from the inspections
or other acts of Agency relating to this Agreement.
(4) The Agency agrees to indemnify Central Hudson for any money, damages, liabilities,
administrative and/or legal expenses incurred by Central Hudson as a result of the
Agency's breach of any covenant or failure to meet any requirement set forth in Appendix
"A"'.
(5) The parties agree that this Agreement is complete on its face and may be amended or
modified only by written agreement between the parties hereto and further that any related
prior agreements or understandings are of no force and effect after the execution of this
Agreement
(6) The parties hereto agree that if any provision in this Agreement is legally unenforceable or
inoperative for any reason that the remRin;ng provisions shall be unaffected.
(7) The duties, obligations and rights set forth in this Agreement shall be binding upon the
heirs, assigns, and successors in interest of all parties hereto.
05/18/2012 08:14 845 2847685
c
il''1bj:t t'. UUj/ UUb
- 2 -
(8) It is mutually agreed by the parties hereto that the waiver ofpertormance of any of the
tenus of this Agreement or of any breach thereof shall not be held or deemed to be a
waiver by Central Hudson of any subsequent failure to perform the same or any other term
of condition of this Agreement or of any breach thereof.
(9) Either party hereto may terminate this Agreement at any time in its sole discretion upon
ten (10) days written notice to the other. Any obligation accruing or arising under the
provisions of this Agreement or Appendix A, attached hereto, prior to such termination,
shall survive such temrination. Such obligations include, but are not limited to, those
obligations arising under Paragraphs 3 and 4 of this Agreement and Paragraphs 7, 10 and
11 of Appendix A, attached hereto.
U:J/I::l/ilJ Ii 1J1:l. 1'1 b'l:J i::1'1 fb::1:J
L.
""Oww r. VU../ uuo
APPENDIX A
CENTRAL HUDSON GAS & ELECTRIC CORPORATION
REOUIREMENTS FOR AN ELECTRICAL INSPECTION AGENCY
Central Hudson Gas & Electric Corporation ("Central Hudson") Tariff provides that no electric
service connection shall be made to its system until an inspection is made by a qualified pany and a repon
submitted to Central Hudson certifying compliance with the National Electric Code ("NEC") and the Building
Code of New York State, including regulations adopted hereunder, ("Code") and of the political subdivision in
which the inspected premises are located. Central Hudson will accept inspections made by inspectors authorized
to perform pursuant to the Code.
Central Hudson requires that any private non-municipal fum., agency or corporation performing
such illi.--pections ("Agency") meet certain standards before recognition and acceptance will be given by Central
Hudson to inspection reports issued by the. Agency. These standards are established to insure that adequate and
proper inspections are made so as to protect the health, safety and welfare of Central Hudson's customers.
Central Hudson requires tIle following conditious to be met by any Agency making these inspections. These
standards do not apply to designated public officials.
(1) Before commencing work hereunder, Contractor shall furnish to Owner a certificate or
certificates of insurance, issued by the company or companies issuing such insurance, evidencing
that Contractor has insurance for its own work operations in amounts no less than those set forth
below, evidencing that such insurance is in full force and effect, and expressly providing that no
such insurance may be cancelled or changed without at least thirty (30) days' written notice by
certified mail, retum receipt requested to Owner at the above address, Attention: Contract
Section. Contractor shall notify Owner immediately of any cancellation or change in coverage in
such policy or policies. Contractor has the duty and responsibility to keep such certificates and
endorsements current and effective at all times during the term of this Contract. Owner reserves
the right to suspend services and/or withhold payment if at any time such certificates and
endorsements are not current and effective and/or Owner has not been furnished with current and
effective certificates and endorsements.
(a) Workers' compensation and employer's liability insurance in accordance with the statutory
requirements of the state where the work is performed.
(b) Comprehensive automobile and vehicle liability insurance covering claims for injuries to
members of the public and damage to property of others arising from the use of motor
vehicles, including owned, non-owned, and hired vehicles, with Bodily Injury limits of
$2,000,000 and Property Damage limits of $2,000,000.
(c) Commercial general liability insurance covering claims for injuries to members of the
public and damage to property of others arising out of negligent acts or omissions of
Contractor or any of its employees, agents or subcontractors, with Bodily Injury limits of
$2,000,000 and Property Damage limits of $2,000,000, and endorsed for contraCtual
liability.
(d) Professional liability insurance in the amount of $2,000,000, including coverage for errors
and omissions caused by the Contractor's negligence in the performance of its duties under
this Contract.
.;
0814 845 2947695 C rGbj~ r UU~!UUb
Owner will he uamed as a primary additional in sured with respect to ContraCtor's liabilities
hereunder in insurance coverage's identified in items (b) and (c), and Contractor waives
subrogation against Owner a'i to the coverage provided pursuant to items (b) and (c).
05/19/2012
All insurance policies shall be issued by insurance companies listed and admitted to do business in
the State of New York that are acceptable to Owner and are rated "A" or better by Alfred M.
Best Company.
(2) The Agency shall furnish Central Hudson with proof of financial responsibility and organizational
continuity, approval of which lies solely within the discretion of Central Hudson. The Agency
shall not solicit of any person or entity or require, as a condition of inspection, any waiver of
responsibility of an error, omission, or recommendation made by its inspectors, or for any other
action of its inspectors.
(3) 1be Agency shall require all wiring to IIlflet standards of the latest revision of the Code, and all
other applicable codes prescribed by the State of New York or the political subdivision in which
the inspected premises are located and applicable rules and regulations of Central Hudson.
(4) The Agency shall not compete with others in any manner that would cause it to reduce the quality
of its inspections. The Agency shall not knowingly accept an application at any given location
from any applicant who has received violations from another Agency.
(5) Each Agency is required to maintain a file of current inspection charges with Central Hudson.
Established charges will be applied unifonnly and will not be discounted. Inspections and reports
shall be made only by qualified electrical inspectors permitted to make such inspections by the
Code and all other applicable govern.mental requirements. The Agency sball insure that the
inspectors they employ have adequate experience, education and training as follows:
(a) Have a working knowledge of the principles of electricity necessary to interpret the
National Electrical Code (NEC), the Codel and other applicable requirements.
(b) Know the requirements of the NEC, the Code, and other applicable requirerrents.
(c) Be familiar with. the construction practices of the electrical wiring trade.
(6) TIle Agency, its employees and work.'lIlen. shall comply with all federa!l state and local laws,
ordinances, rules and regulations pertaining to any electrical inspection.
(7) The Agency agrees to maintain adequate records so tbat it can provide Central Hudson and
applicable officials with records of inspection when requested. Such records will be maintained
for a minimum of five years.
(8) 1be Agency will maintain an office in the Central Hudson service area, manned to receive
telephone calls during normal business days for a minimum of 6 hours per day. If the Agency
does not maintain a local office, it will be required to obtain permission to perform inspections on
a temporary basis from the Company Utilization Engineer at least three (3) days prior to
performing any inspection work.
05/18/2012 08:15 845 2847685 C
~LJ(:r-13-20W:l 1 S : 54 CEt-lTR~ HUtSON, ' ,,645 486 5746 P. as
;';1'; "- (9) n. t\3ear;y IbaI1 estabtiah llyltem to ~ 'PYlicl1~w and il~~~cticIl reponl in
(/' , . ~rdIDCe with tht foUowiq:
. ,
. '
, ..
:; ;" (I) ~ ~y Ihell prc~ ID application form which mall ~Jl.Jde a Q)PY for the ~~
~ ~tll.au (~r any otbllr reqund .O~~ .\~Dit) BD4 tl>> app1junt.
l,,:J':.
;'1 I
"
it,'}
!,
\J'
1
it
t\.
, ,\
:4D::;~ t" UUb/UUb
(b)
l'bD AifDt;}1 1baD i.mae . tempomy emi&::atD to ~Dt1'il Hud~Il givm, DOUce th8l a
~ ~n hu beeI1 rnDd:' and it is safe to eaerpe !be aeniec.
(c)
The AsSDC)' 8ba.U establim .. ~ure fol'~. ootificatioa of any %lOn--co~1iance.
TbilI aotk:e shall't=' Kf'Ve4 OQ me CPP,~1e buikiiDi dep~:~,{lIlOdJor WJy other
requited eo.~UU _j af&d.~ app~ , ' ,
(d)
ThI AgeDq ab&D 1Nue a ~jficlltc of compliance aod abIIll,provide I copy of tbe
ccrtifi,c_ to U. eppl~nhle ~ ckp~ (itldIOt GU}' otl\er RJiuired eo~
\mil) ~ '~' 1pJiliu.nt. '
; :'
~. ~
l' ::,
. ",
(e)
Th8 ~ &bill esclb&h Iud maiutain, qu&lity a.nur~ - q~alli, ooutrol ~ifam in
order to UM that ~ iDJlatctiOu coDduCted by the Aglmcy (aDd the Nlated
\ ", ,
~Otl)wil1lDMt'U. foIlowm; r~s:
~ I:'
~ ':'
\ "
t '
i :.
r, "
, ..
"
. Implemrd stmdardlOr hi1na q~ PeT&;'~l;
. RoutiDeJy 8Ud.."tiD~; : ":. ,,' , " '..<, " "
~ CoDduct regWar' tramm, 'PW'arar= by wh!ChGlldl iupecto1' t; kept aware of all C1.UTeD1
1pp1k:able tequftrrenls; , " .
. CoDduct each iDspmto:p ~te:!1 ~ ~Hccb!e. ~,~~,~ J'!q~t.:s; ,
- M.mtIin & J'C~iW'..a 1OW'Ce tOl'lfrm.~e all C'Un"eUt i~ &wi
,,~~~ntJ; ,
J~~!....\mS ~ usun that DO TCl\lJOflry Cut-In Cert1fi~IU: 15 ismrd '\Well an
in8~ hu bu:u tODd:~ed. .
(J 0) When rcq1JHted b)'Centra.1 Hud~ .. ~ or a muoicipa1iIYt the Ai~~ will pcdorm a
reimpe.ctioll of &D ,,aatiq dw~lliq em wbrrlt a fbr.maJ ~rt to the Company. trJlmjcipaHt)' or
a&acon:l!r i:u Icn~1\1. -, ", , . " .,,'. ,;
I, :
~ "
~ h
\ .,
~ I :'
" ,
,.\:
. ~:
I ",
I ~
;1 ~ .
;
I', .
\ I
/'
I "
il l;
(11)
All ~n. wiD be ~Iettd .Dd'~'les'i:18uedin'. ~)y~~ to insure that
cunormra ~ DOt I\l~ to UDdue delay m, ~jvi!ls e~ ~, 'Inspections slWl wtmal1y
t. made withiD 48boun of the no:ipr'oftllt ippliCaooli::'" ,'..', .
. , . .;. ..... . ,. .. .' . . ~ . t .. . .
..
, r
(:
I.. ~ j
~. ;
~ 'WiTNESS WlirBRlroF, tbc parties hereto ha\le ,duly ex.tlCu~ Lhi.s A~ &5 of the day
~) ID&1 'ftIlt t1rst &bo~ wnttu. ' ' '" ' ,
i,' -' '~J
ill ~
, " Ar.rBST;
I I
','l
( .I
\, .
> I
; .'1
. ' ATIEST:
~ '\ '.'
I ,
I .
': ;~
C H, N CAS " ELECTRIC CORPORA nON
',.;' , " .
By: '"c,~9...,.~t"~.. '.~'~:raulE. H~
"