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HomeMy WebLinkAbout51367-Z w TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 51367 Date: 11/08/2024
Permission is hereby granted to:
Angela Cordero
31-15 90th St
East Elmhurst, NY 11369
To:
Install a new gas boiler to convert the heating system of an existing single-family dwelling from oil to
gas as applied for per manufacturers specifications.
Premises Located at:
66225 CR 48, Greenport, NY 11944
SCTM#40.-2-9
Pursuant to application dated 11/07/2024 and approved by the Building Inspector,.
To expire on 11/08/2026.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $250.00
CO Single Family Dwelling-Addition /Alteration $100.00
ELECTRIC -Residential $100.00
Total $450.00
Building Inspector
r
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O.Box 1179 Southold,NY 11971-0959
n Telephone(631)765-1802 Fax(631) 765-9502 hItp 'L ogtlioldt !1g�.�y
Date Received
APPLICATION FOR BUILDINGPERMIT
For Office Use Only
5 I lD �
PERMIT NO. I Building inspector. ..-._.. ��
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant Is not the owner,an WG 1 °° 7.
Owner's Authorization form(Page 2)shall be completed.
Date:11/512024
OWNER(S)OF PROPERTY:
Name:Angela Cordeo scrM# 010- Q ,Z—
Project Address:66225 North Road. Greeport
Phone#:646-314-2717 Email:Mianmal@aol.com
Mailing Address:66225 North Road. Greenport
CONTACT PERSON:
Name:Angela Cordeo
Mailing Address:66225 North Road. Greeport
Phone#:66225 North Road. Greeport Email:66225 North Road, Greeport
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:Vincent DeGennaro
Mailing Address:61 Drake Avenue. Bellport
Phone#:631-422-9565 Email:villyhilltop@aol.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition IRAlteration []Repair ❑Demolition Est' acted LCosttlof Project:
❑Other
Will the lot be re-graded? ❑Yes igNo Will excess fill be removed from premises? ❑Yes ANo
1
PROPERTY INFORMATION
Existing use of property:Residential Intended use of property:Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
A this property? ❑Yes ❑No IF YES, PROVIDE A COPY.
❑Check Box.After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building zone
Ordinance of the town of Southold,Suffolk,County,Now York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and regulations and to admit authorized Inspectors on premises and In bullding(s)for necessary Inspections False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law.
Application (print name): �Authorized Agent ❑Owner
PP Submitted B Y
4nA
Signature of Applicant: Date:/ / aPP
g
STATE OF NEW YORK)
SS.
COUNTY OF "r4('
¢ ) being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the / ' " -
(Contractor,Agent,Corporate Officer,etc.)
of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this
application;that all statements contained in this application are true to the best of his/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file there ith.
Sworn before me this
day of 20 2�
Not Publi
ANTHONY R ALDJ--,
HotarY Public-St of
No.OI AL64076 �I I �OWNER U'TH ,M "
NAY Qualified In surer Where the a plicant is not the owner)Expires.t ( p
residing at ( 2 1
do hereby authorize to apply on
7mehalf to the wn of outhold Building Department for approval as described herein.
Owner's Signature Date
!1� r o 7/i 4) � (�
Print Owner's Name
2
HILLT-1
F�l
E(MMIDD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 1/07/2024
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, tt
00 North Broadwa St 143 516 932 8100 -ins.com�I.i . 16� m1- 3
PRODUCER 516-932-8100 Nei Serrano
Grace Insurance Agency,Inc PHONE Fr
.......,,,, c Noi
NY 5 grace
D&A Jericho,Agency-Commercial
1 _. netts Serrano
..,. JM7SURERi1 AFFoflolrap ctvERaciE..................
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Mutual Insurance Co 23329
k p INgyMR..A Merchants M. w
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INSURER B The State Ins.Fund .. 36102
lumbing&Heating Inc ____ -
Vincent Degennaro INSURER,c Shelterpoint Life Ins 81434
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61 Drake Avenue
Bellport,NY 11713 INCURER;,O , --, ..--
INSURFR,.E ........_......................._................ ..... ....
INSURER F:
COVERAGES E T FI ATE 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 NSR DDL POLICY EFF POLICY EXP
CLAIMS.
LTR
' ..... TYPE OF INSURANCE ...,.,,.,..iUBR ............. .... ...... _.v.,... .._.....,-,...... ....._...... ..,,....�___ ...... ...... .... .... ......__ .....
INsn POLICY NUMBER LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH 1 000 000
DAMAGE TO RENTED 500,000
C ntr CLAIMS-MADE
E i X ,OCCUR X BOP9094236 04/23/2024 04/23/2025 pR 1.F5(F, gpnvrmm
X MED EX,P(�An,.Y one erson .... $................maaaaa.....
15 000
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Gg:N'L AGGREPATE LIMIT APPLIES PER: gE,N,fR AgGREGATF 2 ,000,000
POLICY X P LOC PR O D UCTS CO- MPIOP AGG 21000,000
11 :R'
AUTOMOBILE LIABILITY -CO � lMrr
ANY AUTO �DYIJURY Per o n
OWNED
SCHEDULED „BOR&nNJLIRY�,Peraccident $
ALI ONLY ...... AUTOS ONLDerO�tlRrfe
UMBRELLA LIAB OCCUR EACH OCOl1RRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENT,........,,.
... ION$
B WORKERS COMPENSATION X PER UTF
OTH
AND EMPLOYERS'LIABILITY ...µ JRTtT,.,. . w.,,........F........_ ................._.......,,. ,µ.,0 ,000
r!J P 1,000,000
23405939 07/30/2024 O7/30/2025
ANY PROPRIETOR/PARTNER/EXECUTIVE E�L.EACH A IDENT
FlCF,41FME,MBER EXCLUDED? Y N I A
landalo in NH
�"1" ) F L., IyEASE-EA EMPL YEE
If yes,describe under 1,000,00tj
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C Disability D209893 01126/2024 01/25/2025 Statutory
I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
Certificate Holder is included as additional insured as per written contract
CERTIFICATE
SOUTHLD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town Of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 1179
53095 Route 25
Southold, NY 11971 AUTHORIZED REPRESENTATIVE✓�
ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
NYSF
New York State Insurance Fund PO Box 66699,Albany,NY 12206
1 nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE (RENEWED)
AAAAAA 113425726
GRACE INSURANCE AGENCY,INC
500 N.BROADWAY ® "
SUITE 143
JERICHO NY 11753 SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
HILLTOP PLUMBING&HEATING INC TOWN OF SOUTHOLD
61 DRAKE AVENUE PO BOX 1179
BELLPORT NY 11713 53095 ROUTE 25
SOUTHOLD NY 11791
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
12340 593-9 356149 07/30/2024 TO 07/30/2025 11/7/2024
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 2340 593-9, 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, AND, WITH RESPECT TO OPERATIONS
OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY.
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 POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE
INSURED CORPORATION.
PRESIDENT
VINCENT DEGENNARO
HILLTOP PLUMBING&HEATING INC
ONE PERSON CORP
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
4
t4l
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER:471325464
U-26.3
y� Suffolk County Dept of
Labor,Licensing&Consumer Affairs
„ f
MASTER PLUMBING
���1J1Jn(dbY
Name
VINCENT DEGENNARO
'..� Business Name
' �' HILLTOP PLUMBING&HEATING INC
This certifies that the
bearer is duly licensed License Number MP-45240
by the County of suifolk Issued: 09/03/2008
WagweiT. R,oyery Expires: 09/01/2026
Commissioner
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HILLT-1
CERTIFICATE OF LIABILITY INSURANCE DATE(M0120 4
04/31202
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 endorsement s,
PRODUCER zwo Nedi Serrano
Grace Insurance Inc A N 516-932-8100 1 FAX 515-51-0313
00 North Broadway Ste Agency,43 516-932-E1100HONE rExti_ ... ...._ ..._ ww ...._�i Noi.:.. .... .....__ w.........
Jericho,NY 11763
D&A Agency-Commercial net3i Ferran race
_.... .... ants Mutual
FundrslaralncaCo
n23329
Thtate lns ..... _...._ .... 36102c 'µ..........
100al Numbing&Heating Inc INSURER B Shefterpoint Life Ins 614
Vincent Degennaro, irlsu . _ .... . .....
61 Drake Avenue IN6iRR p
Bellport,NY 11713 _.. .......
INSURER F
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 AVE BEEN REDUCED BY PAID CLAIMS.
IiIffiPt ... ..UOR .... .... POLICY NUMBER _. ... ..... C 11000,000
LTR
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MERCIAL GENERAL LIABILITY LIMITS SHOWN MAY H BE.
POLICY EXP, LIMBS
POI,IY EFF I EACH OCURRh9... .....
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X..., .WP CLAIMS-MADE X MAGE TO RLI CFO 501I,0
II occuR X BOP9094236 �04I2312024 04/23I2025 I3ENwaE .4.E �Vllaail ) ._. ...
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15,
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G IL ACaGRE APPLIES
it 2,000,000
m SATE LIMIT APPLIES PER. t NERAL AC�SREC' TE '
PRO- Paalr a1rzl.Ar, .1 . 2 000 0
POLICY�X�JECT �LOC °•
LIMIT
AUTOMOBILE LIABILITY f�IwINED SINGLE .
...........
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ANY AUTO bDCLY I1UkVP wetapt S.
OWNED ..._ SCHEDULED
AUTOS ONLY AU��T��ppOS Fp;�t b�IAMAGE
AUTOS ONLY _,,....... A11TOa�t7NLY (Pategro@L... ......, .. _....... ..
UMBRELLA AB 0 CUR
EXCESS LIAB CLA4MS•4WIAOE APGRI�CsA...TE ®.,..,... ,...,.
B WORKERS
ND EM SCOMPENSATION
YERB LAB L�TYN$
X 5 T -, - 1,000,000
Y I N0713012024
ANFIgtory �A�,CLULO IIECUINE "'' NIA 23405939 07/3012023 EL EA HACCIDEINT t
Q._ .... I. 051"SL.,f a EM I r x, ..1.. . _1,O011„OO"i
1,000,00
LIMIT S
i8 es,describe under QPLW_T hI t
I� "(
C Disability D20989 0112612024 01P2W2026 Statutory
Remarks Schedule may be attached If more space is required)
!VEHICLES ACORD 101 Additional R Y
DESCRIPTION OF OPERATIONS/LOCATIONS ( ,
Certificate Holder is included as additional insured as per written contract
CERTIFICATE HOLDER !gANC LATION
SOUTHLD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 1179
53095 Route 25 AUTHORIZED REPRESENTATIVE
Southold,NY 11971
ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
r C-("
Hilltop Plumbing and Heating, Inc.
61 Drake Ave.
Bellport, NY 11713
Suffolk (631) 422-9565 Nassau (516) 933-1761
Vinn hillto caol.com
Residential/ Commercial
Licensed & Insured
Re: 66225 North Road November 7, 2024
Greenport,NY
To Whom it May Concern,
We at Hilltop Plumbing&Heating,Inc., are proposing to install one new combo Gas Boiler with
New Gas Line from existing gas meter to new boiler and requesting a plumbing permit to be
issued as soon as possible. We are writing this request because the existing oil boiler is not
working, and the owners have no heat or hot water.
As per your request,we are also forwarding a copy of the specs.
Thank you, APPROVED AS NOTED
B.P. 13
Vincent DeGennaro ELECTRICAL
Hilltop Plumbing&Heating, Inc. INSPECTION REQUIRED NOTIFY BUILDING DEPARTMENT AT
631-765-1802 8AM TO 4PM FOR THE
FOLLOWING INSPECTIONS:
FOUNDATION-TWO REQUIRED
COMPLY NTH ALL CODES OF FOR POURED CONCRETE
NEW YORK STATE&TOWN CODES ROUGH-FRAMING&PLUMBING
AS REOU I RED AND CONDMONS OF INSULATION
FINAL-CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
KX&DM REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
WSW
!9= WC DESIGN OR CONSTRUCTION ERRORS
r,ry
QUckFactc.
NCB-E Series
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CCJf"1`bi-boilers
avian certification summary Gas inp
ut ranges
Model..,,,.,u..,_.w_.___......."...M.....� �.___w__......µ,".,...."..�." ................._.,.."..w_..... ....,. _._.._...._.._,.___„ ,_..... ,,...,
Model Heating(aTUlH) DHW(BTU/H)
r 180E NCB-`�tOE A1CB-240E
NCB-1SOE NCB= NCB-150E 12,060-60,000 Approvals 12,000 1za OOb��
Product A NCB 180E 14 000 80 000 14 00U 15G 000
_...._ -
`""""' NCB-210E 18 000 100 000 18,000 180 000
CSA Yes Yes Yes Yes
NCB-240E 78 000 120 000 16 000 199 90o
SCAQMD 1146.2 �_....,.ww......,.,,,_.....,_.�_..
Yes Yes Yes Yes -�_.._...."_ .....,M. �_„„
(NOx,<20 m Warranty
L lead
PP.,m�.,.. _-.-.- e_,. jY
leadH" e Yes Yesn ial single family use on 1 year 5 year" 70 ygASM 5�6,DHW onl ° ..,.. _,...oneaw� Yes H" Ys�k-d� Y�°Hf" Yas„H„ er
y} Type
Lehor Parts Heat Exchanger
stamp starnp stamp stamp *Includes DHW flat plate HX,
AHRI Number -0 9580771 8580772 For complete details please refer to the full warranly at Navienlnc.com.
k. 8580i69 BSBG7i
Energy Star Yes Yes Yes Yes Applications
Hydron
__., S 95 0 Heating R95 Q s g5 0 gg 0W µ Handler....,.,..,.., w, nia ran calls Basaboaid rad a ra�rs� R M W i
_ TMTM P 9 g Air
AFUE,96" Hydro_........ - adiant tlaars
w ."" For NOB tNt°a-E ta¢d r 1W do 1 ings of specific installations
Heating Capacity MBH 56 75 94 112 aey isit Navienlnc oom
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Product features NCB-E:the inside story
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�_,......_ _._._. ._........_..., w-..
TOuP rca Reduces energy 2"PVC
D ®-1 ^0 waete and excessive I Pressure
I n 11:1 DIM iperab re control r schedule 40
for CHIN relief valve capable up to 60'
Dual far easy field Venturi „ 2 PVC air
Heccgnxed as the Y Intake venting
��� B convertibility
Af9E 95
most efficient in 2018 I r
1 �� by Energy Star 1 Powder-coated
Primary r enamel metal
stainless steel ! housing
t
heat exchanger,
1
2'=3VENTING Z avc venting up,o 50 l Secondary
LONG OI TA CES T PVC venting up to 150
Stainless steel ® stainless steel
fie L.„�""..�., flat plate neat _ heatexchan 9
er
�li
exchanger
for domestic Integrated
HTGOINOne unit does it ail wito hot water control panel
120 8MIlt I99RtTUPo tv"o outputs
—"� Integrated d� Negative
boils pump t, 4 pressure
gas valve
�� Prima heatin
Primary g y r
e HH9 GpS All Navien products ere tw Heating system
Held gas convertible loop supply auto-fill
Primary heating
Domestic heft
loop return
rtt "� Water inlet
hum1/2" pipe
as i e g Domestic hot
_. capable UP 24 ..,...w_ ..._. ...,.� __ water outlet
wat