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HomeMy WebLinkAboutMP11-027 �yE DR C�4CVJV°Ji VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J.Bradbury www.ryebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R Epstein Steven E. Fews David M.Heiser Donald T.Krom,Jr. Salvatore W. Morlino CLARIFICATION OF RECORD April 28,2025 Anthony Alessi&Christine Alessi 239 North Ridge Street Rye Brook,New York 10573 Re: 239 North Ridge Street,Rye Brook,New York 10573 Parcel ID#: 135.35-1-16 Mechanical Permit#11-027 issued on 6/30/2011 for Two Above-Ground Propane Tanks Following a site inspection of the above captioned property on April 28,2025,it has been determined that the two above-ground propane tanks have been removed from the premises.Therefore,this letter&attached inspection report will serve to close out the subject permit. Sincerely, Steven E. Fews Building&Fire Inspector /to �yE BRC�k O� Zm 1982 BUILDING DEPARTMENT [I BUILDING INSPECTOR uy ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www.ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- �� f 'y QZ T�] L iJ�_ .�S 7 zay-� DATE: / � �� �y� PERMIT# M /o YJ- D 2-7 ISSUED: -.20-/- SECT: 13.E 3L BLOCK: LOT: LOCATION: K Q OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... �] ACCEPTED ❑ REJECTED/REINSPECTION & ITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS j p'L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER " ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER s , a s s r- OC z w � _ o `r' A 0 d O co Q � wWOC) �ccn Uw Q w COO cn � z a w z • O a M z z o A o W z � a � � O U O a v A v a w a a w i D — VILLAGE OF RYE BROOK JUN 2 8 2011 DD BUILDING DEPARTMENT 938 KING STREET, RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (9 4)939-0668 FAX: (914)939-5801 www.r yebrook.or BUILDING DEPARTMENT � PPLICATION TO REMOVE ABANDON AND/OR STALL FUEL STORAG TANK UP TO 1100 GALLON CA CI (*Storage tanks in excess 00 all uire registration with th ty estchester) I Permit#: `�^ lding Inspector: Fee Paid: I J V - Date of Approval: (fees are non-re undable) REQUIREMENTS FOR RELEASE OF PERMIT& CERTIFICATE OF COMPLIANCE: 1. Application Completed by Bonded, Licensed Contractor 2. Copy of Licensed Contractor's Insurance including Liability & Workers Compensation (naming the Village of R Certificate Holder) 3. Fee: Removal/Abandonment: $150 Installation: $15 4. Dig Safely New York#: 5. Inspection by Building Department for removal/abandonment & installation 6. Manifests & Reports (after work has been completed) 7. Certificate of Compliance will be provided when all requirements are fulfilled Application is hereby made to the Building Inspector of the Village of Rye Brook for the approval of a permit for the removal,abandonment and/or installation of a Fuel Tank(s)herein described.The applicant,by signing this document agrees that said Fuel Tank(s)will be installed,abandoned and/or removed in conformance with all applicable Local, County,State&Federal laws,codes,rules&regulations. Indicate either above ground tank or buried in-eround tank. 1. Property Owner's Name: 4 7714,--) 4e-U1 N-S u A1 Phone#: 7 2. Job Address: Z-3`7 rVbA-f�f Phone#: V f,1139— `?0,�9 3. Parcel I.D. #: 135.�35,44(v ( 0-1-16—4 Zone: 4. Contractor: 6x5 La� Phone#: 2/ 1-9 f, 3031 5. Contractor's Address: On 1Jr7f'7yA&-UT� eve Fax #: 73 7--1i f 6. Exact location of tank to be Installed: above ground Z91und ❑ 7. Exact location of tank to be Removed: above ground❑ in ground❑ 8. Exact location of tank to be Abandoned: in ground only 9. Distance of Tank from Structure: M iN,.,4-ter 10. Distance of Tank from Property Line: 11. Type of Fuel: Oil:❑; Propane�Gasoline:❑: Other: 12. Number& Capacity of Each Tank: Signature of Applicant: --- _ Date: Printed Name of Applicant: 4 e u w $X a y Z z i r888 $ ° s W Q Z =LL o N W aQ Q 0 a000a rg o _ 3 N= o z Q O W U U �a K Np ZF LL2 O KU yv� w %p a �J p N 2y<� �Oy DO 0 '{ �J v N N K< QpQ Wy<y <^. p ` _ i< U' �S K rtt v�t/<1 (, Z ? j j Z J ] N a >O N W << z_u g K g Q Q " x 3u <rN ' o z� aJ �"cg n ��S2aw0 }R� wa D e N U 1 a '� pvu LL i Or w� wZ w m u �www F Z>`S N 8v7N� 0� W a '� om w o z n rx n o, cxiN LL� ¢�c! i u�((�//��!/�!/��� OnS p m wn� m a n Z Yr a OWe LL Z U ONa NNW"% % O? Q = F Q o o < Y a °ate zz $ < w�?mm Wa c9 02� a w Q Z z W? 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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 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: Alice Lara Fairfield County Bank Insurance Services PHONE , F_AX 401 Main Street A/C No Ext: g3-43R-0404 Nok203-431- E-MAIL CT 06877 ADESS: al ice.lara®fcbins.com PRODUCER CUSTOMER ID N:PARAC-1 INSURER(S)AFFORDING COVERAGE NAIC N INSURED INSURER A:Liberty Mutual Ins. Group _ 23043 Paraco Gas Corp., Paraco Gas of CT Inc. INSURER B:Everest National Ins. Co. 10120 Paraco Gas of NJ LLC 800 Westchester Avenue, S604 INSURER C:Lexington Insurance Company Rye Brook NY 10573 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1078125055 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. INSR ADDLSUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY y Y TB164G435685031 1/1/2011 1/1/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $50,000 CLAIMS-MADE F--I OCCUR MED EXP(Any one person) $5,000 PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 �GEINLAGGREGATELIMITAPPLIESPER PRODUCTS-COMP/OPAGG $2,000,000 J CT POLICY PRO- LOC $ AUTOMOBILE LIABILITY AS1641435685041 1/1/2011 1/1/2012 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $1,000 PPT DED $ $5,000 TRUCK DED $ B UMBRELLA LIAB X OCCUR 71G4000088-101 1/1/2011 1/1/2012 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION WC264G435685050 1/1/2011 1/1/2012 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PRO PRI ETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 IF es.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Excess Umbrella 71G4000088-101 1/1/2011 1/1/2012 $5M Aggregate $5M Occurrence DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) 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 Street Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE J� / A ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD • • STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of Insured 914-250-3700 Paraco Gas Corp. 800 Westchester Avenue,S604 lc.NYS Unemployment Insurance Employer Rye Brook,NY 10571 Registration Number of Insured 67-109415 Work Location of Insured(Only required if coverage isspecifhcally 1d.Federal Employer Identification Number of Insured lineited to certain locations in New York State,i.e.,a Wrap-Up Policy) or Social Security Number 13-3149941 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Liberty Mutual Fire Insurance Company Village of Rye Brook 3b.Policy Number of entity listed in box"la" 938 King Street WC264G435685051 Rye Brook,NY 10573 3c. Policy effective period 1/1/11 to 1/1/12 3d. The Proprietor,Partners or Executive Officers are x included. (Only check box If all partners/officers included) ❑ 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"la"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"T'. Thelnsurance Carrier will also notes the above certificate holder within 10 days IFapolicy is canceled due to nonpayment ofpremiums or within 30 days IF there are reasons other than nonpayment ofpremiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate (These notices maybe sent by regular mail.) Otherwise,this Certificate is valid for one year after thisform is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box 113c11,whichever is earlier. Please Note:Upon the 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: Robert E.Spadaccia (Prin(name of authorized representative or licensed agent of insurance tamer) Approved by. ) j j a ) Title: President—Fairfield Counly Bank Insurance Telephone Number of authorized representative or licensed agent of insurance carrier: 203-894-3145 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(9-07) www.wcb.state.ny.us