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Home My WebLink AboutMP14-073 44�y Jd '�1f] 4 Wtl u v J V ' f 4t"�q" QtLfdumaxe 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 Michael J. Izzo Stephanie J. Fischer David M.Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE December 21,2022 Vincent Barbarisi&Barbara Goodstein 1 Rock Ridge Drive Rye Brook,New York 10573 Re: 1 Rock Ridge Drive, Rye Brook,New York 10573 Parcel ID#: 135.43-1-36 This document certifies that the work done under Mechanical Permit #14-073 issued on 6/23/2014 for the removal of an above-ground oil tank has been satisfactorily completed. Sincerely, Michael J. Izzo Building&Fire Inspector /to QyE 4RO cu � Fo BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑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 Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :— a DATE: t ' SECT: BLOCK: LOT: COO /L' PERMIT# ' ` ISSUED: LOCATION: , C�V` OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER AL OR�� DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/23/2014 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 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. PRODUCER CONTACT NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 A C. .. Ext:888-333-4949 (A C No):507-446-4664 OWATONNA, MN 55060 E-MAIL ADOREss:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 330-130-6 INSURER B: WESTMORE FUEL COMPANY INCORPORATED INSURER C: 86 NORTH WATER STREET GREENWICH, CT 06830-5886 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:35 REVISION NUMBER:0 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DDIYYYY MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence _ CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) EXCLUDED A N N 9062815 06/01/2014 06/01/2015 PERSONAL a ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 X POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED A AUTOS AUTOS N N 9062815 06/01/2014 06/01/2015 BODILY INJURY(Per accidenU NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident.) X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAR CLAIMS-MADE N N 9062816 06/01/2014 06/01/2015 AGGREGATE $5,000,000 DED RETENTION WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE•POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION 330-130-6 35 0 VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK, NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE / O 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD (MMfO ACORO DATE 4/23/2/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04232014 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 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 CLIENT CONTACTE TER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 A CNNo Ext:888-333-4949 (A No):507 446 4664 OWATONNA, MN 55060 ADDRRESS:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 330-130-6 INSURER B: WESTMORE FUEL COMPANY INCORPORATED INSURER C: 86 NORTH WATER STREET INSURER D: GREENWICH, CT 06830-5886 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:35 REVISION NUMBER:0 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 ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD MMIDDIYYYY MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE X COMMERCIAL GENERAL LIABILITY PREMISES( RENTED $100,000 Ea occurrence CLAIMS-MADE [_�OCCUR MED EXP(Any one person) EXCLUDED A N N 9062815 06/01/2014 06/01/2015 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 • 17 LOC X POLICY JECPROT AUTOMOBILE LIABILITY COMB c I ident NED SINGLE LIMIT $1,000.000 X ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED A AUTOS AUTOS N N 9062815 06/01/2014 06/01/2015 BODILY INJURY(Per accident) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS-MADE N N 9062816 06/01/2014 06/01/2015 AGGREGATE $5,000,000 DED RETENTION WORKERS COMPENSATION WC SAT U- OTH- TORY LIMITS ER AND EMPLOYERS'LIABILITY y� E.L.EACH ACCIDENT -- ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L.DISEASE-EA EMPLOYEE (Mandatory In NH) If yes,describe under E.L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space is required) CERTIFICATE HOLDER CANCELLATION 330-130-6 35 0 VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VIL VIL KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK, NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD FUEL CO.,INC. RSeptember 15, 2014 SCP 17 2014 DD VILLAGE OF RYE BROOK BUILDING DEPARTMENT Rye Brook Building Department 938 King Street Rye Brook, NY 10573 Re: Permit#MP-14-073 Subject:Tank Removal on September 3`d 2014 Barbara Goodstein 1 Rockridge Drive Rye Brook NY 10573 To whom this may concern; On September 3`d 2014, Westmore Fuel Company completed the removal of(1) 275 gallon flat from the interior basement located at the subject location. Prior to the removal of the tank, all liquid was pumped; the tank was transported to the Westmore Fuel Company yard at 86 North Water Street, Greenwich CT to be used as a temporary fuel tank. All liquid product was transported by EGC Environmental Services, Inc. a Connecticut licensed transporter. Ver t ly yours, Glenn Nadin Operations Manager Westmore Fuel Co. Inc. Le J 86 North Water Street • Greenwich, CT 06830 • (914) 939-3400 • (203) 531-6800 • (203) 531-5783 • www.westmorefuel.com CT State Contractor's License#308868 • HOD#44 NON-HAZARDOUS 1.Generator ID Number 2.Page i of 3.Emergency Response Phone 4.Waste Tracking Number WASTE MANIFEST G` 1i'� ! r i� a+:J1 x�'- !'61".1 1 <1 pV '_:D P f} 1 :? u 5.Generators Name and Mailing Address Generator's Site Address(if different than mailing address) iFveslr'rySi e:=ctei G,t;gnvtic--Yt CT 38G32 Generator's Phone: -srI) 6.Transporter 1 Company ame U.S.EPA ID Number -*ri ='niir.r.•ti u What L�rarytivary i 1 I '-1 7 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number girt{�GpOft llr;rte�!i4e:�,,;cfiny,!etc. 5ti v'rLss Street Facili 's Phone: r.z ;1�_i 13 Gft T F1 Ft t` P R 7 9.Waste Shipping Name and Description 10.Containers 11.Total 12.Unit No. Type Quantity Wt.Nol. ¢ 1. ndcn-RCI?A,Tian-DOT(t"1LY DEORISi SOLID? k W J u `i DN'. 2. 3. 4. 13.Special Handling Instructions and Additional Information 11 14NC DE0124 f'C*Jc,!09;,8 h POC"ii E: ..BN,.AS,1 `4AGH'r IS AN F.T"?.,1h7•E_ 14.GENERATOR'S/OFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations. Generator's/Off roes Pr fiCyped Name Signature Month Day Year J 15.International Shipments I- ❑Import to U.S. ❑Export from U.S. Port of entry/exit: Z Transporter Signature for exports only): Date leaving U.S.: ¢ 16.Transporter Acknowledgment of Receipt of Materials Transporter.1 Printed ed Name Sgnatu� Month Day Year Sir r C :�` � ,�� r-)l�t !` N Transporter 2 Printed/Typed Name Signature Month Day Year t- 17.Discrepancy 17a.Discrepancy Indication Space ❑Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: T 17b.Alternate Facility(or Generator) U.S.EPA ID Number J rU ua Facility's Phone: w 17c.Signature of Alternate Facility(or Generator) Month Day Year a 2 N W C 18.Designated Facility Owner or Operator:Certification of receipt of materials covered by the manifest except as noted in Item 17a PrntedrTyped Name Signature Month Day Year 169-BLC-0 5 11977(Rev.9/09) GENERATOR'S/SHIPPER'S INITIAL COPY