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HomeMy WebLinkAboutMP23-041 BRCS f' VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.ryebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE August 12,2024 Edward McLaughlin&Jean McLaughlin 24 Westview Avenue Rye Brook,New York 10573 Re: 24 Westview Avenue,Rye Brook,New York 10573 Parcel ID#: 141.35-1-36 This document certifies that the work done under Mechanical Permit#23-041 issued on 4/10/2023 for the installation of a new above-ground oil tank has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE BRC��. cu � 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR QASSISTANT 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 : '!1l L ST k1/4- .,i A V E DATE: Z U L/ PERMIT# 11-7 P ��� U �� ISSUED: SECT: / -2-�- BLOCK: / LOT: J b LOCATION: 'z"' 7 / S �lJ'�./� Y� 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 p L.P. GAS �[] FUEL TANK ❑ FIRE SPRINKLER G✓ T C c f U ❑ FINAL PLUMBING / ❑ CROSS CONNECTION Q FINAL ❑ OTHER : a p' L x � w ■ � O O � py � s qj 1 �4 O44 � q co � O � � o � d •� a,v ay oO {n I/ O vo p C 8 g W E V ■ O A V ,� a ui v (j (> � a � O U Z v ' yr `{ a 00 _ z > p � U •� V � A a r +� �Oooc� .� y M W 00 x x �,� •� � o Q4 cn Z Oa C G FW = a V �1 U W o o ° Vro � p U C U w i � o � w O A 0 .4 F� N z o � Qao a ECENE BUILDING DEPARTMENTRVIL&ET E OF RYE OOK APR - 6 2023 938 KING RYE BR6,,NY 10573 (914)939-0668 FAx(914)939-5801 VILLAGE OF RYE BROOK &1it.ryebrook.org BUILDING DEPARTMENT _Application for Permit to Remove, Abandon and/or Install Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: O Approval Date: Permit Fee: $Approval Signature: Q6��Vz�� Other: Disapproved: (fees are non-refundable) REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1.Application Completed by Bonded,Licensed Contractor. 2. Your contractor's valid proof of liability insurance.(Village of Rye Brook must be listed as certificate holder) 3. Your contractor's valid proof of workers compensation insurance. (Form#C 105.2 or Form#U26.3 /or NY State Workers Compensation Waiver) 4. Fee per Tank: Removal,Abandonment, or Installation: S 185.00 per Tank. 5. Dig Safely New York#(dial 81 1): 6. Inspection by Building Department for removal/abandonment and/or installation. 7. Submit all Manifests&Reports(after work has been completed). 8. Certificate of Compliance will be provided when all requirements are fulfilled. Application dated, 4/312023 ,is hereby made to the Building Inspector of the Village of Rye Brook for a permit to remove,abandon,and/or install a Fuel Tank as herein described.The applicant and property owner,by signing this document agree that the subject fuel tank(s)will be removed,abandoned and/or installed in conformance with all applicable Village,County,State& Federal laws,codes,rules and regulations. Indicate Permit Tyne: Installation (�•Removal ( )• Abandonment( )/Above Ground (.,T• Buried in Ground ( ) 1. Address: 24 Westview Ave SBL: Zone: 2. Property Owner&Address: Edward McLaughlin Phone#: 914-937-8425 Cell#: email: EDWARD.MCLAUGHLIN88@GMAIL.COM 3. Contractor&Address: Robison Oil 1 Gateway Plaza, 4th FL, Port Chester, NY 10573 Phone#: 914-847-0286 Cell#: email: aolmstead@robisonoil.com 4. Applicant: Robison Oil Phone#: 914-847-0286 Cell#: email: aolmstead@robisonoil.com 5. Indicate Fuel Type:Fuel Oil( •L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: Installation of(1) 275 gal 7. Exact Location(s)of each Tank: Outside- left side of housed on concrete pad with (2) bollards. t 6/I/2020 STATR OF NEW YPRK,CO Y OF WESTCHESTER ) as: 1} lnbeing duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as applicant) and fort r slats that(*)he I�is the legal owner of the property to which this application pertains,or that(s)he is the �[�l l a e l tQ'L for the legal owner and is duly authorized to make and file this application. (indicate�itect,contractor,agent,attorney,etc.) That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform hire Prevention&Building Code,the Code ofthe Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this 1" 0 I- LV-) Sworn to before me this day of 2D = day of ,20 Signature of Property Owner i azure of Applicant '�' )� ('t h t�J b&,— Print Name of Property Owner Print Name of Applicant Nota � blie Notary Public O This application must be properly completed in its entirety and must include the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. amanda K olmstead NOTARY PUBLIC,STATE OF NF:W YORK �•• •., Registration No.01OL6417632 CLAIRSINE ALEXIS Qualified in WESTCHESTER County Notary Public-State of Florida Commission Expires 08/30/2025 Commission X HH 344322 My Comm.Expires Dec 26,2026 P. 6/1'18 i y ?���. 'r i� i � •� a� +4 I t{ �� � 6� �' i ',�`*' �i1,1 4 i '�' �`e' , Y .�____ 'S. J V� ti. G �. � � `s i ? • New Oil Tank Location Basement w 960 Sq ft 32 h Existing DRIVEWAY <C2) 550-Ga on UST Key Benefits Tank Dimensions • Leak-proof and will not corrode Tank ModelDWT DWT DWT DWT r WT • Outer tank holds 110 percent of rrrrOL rrrLH rr inner tank for maximum protection Nom.capacity US gal(liters) 110(400) 165(620) 275 0000) 275(1000) 400(150o) • Up to 50 percent lighter than Length inches(cm) 29(74) 29(74) 43(110) 51 030) 64(163) conventional steel tanks Width inches(cm) 28(72) 28(72) 28(72) 30(76) 30(77) • Can use for heating oil,diesel and Height inches(cm) 44(112) 61(155) 61(155) 54(137) 68 073) bio fuels,motor oil, DEF and ATF Min.height required inches(cm) 49(125) 66(168) 66(168) 60(152) 76 093) • Compact,economical design(8 sq.R.for 1000L) Tank weight lbs.(kg) 106(48) 132(60) 167(76) 208(94) 333(151) Provides maximum storage safety Shipping weight lbs.(kg) 115(52) 143(65) 185(84) 230(104) 358(162) • with minimum space requirements Approximate Footprint for Multiple DWT• Removable base facilitates access to rWT rWT rWT r Installations tight spaces and greater stability , r001-11 r r r • Wide handles on each end allow you 2 tanks in inches 29 x 60 29 x 60 43 x 60 to transport and handle with ease (side by side) (74 x 152) (74 x 152) (110 x 152) (130 x 160) (163 x 60) • Quality control and testing exceeds industry standards 3 tanks in inches 29 x 92 29 x 92 43 x 92 51 x 96 64 x 96 (side by side) (74 x 234) (74 x 234) (110 x 234) (130 x 244) (163 x 244) 4 tanks in inches 29 x 124 29 x 124 43 x 124 51 x 129(side by side) (74 x 315) (74 x 315) (110 x 315) (130 x 328) N/A 5 tanks in inches 29 x 156 29 x 156 43 x 156 51 x 162 (side by side) (74 x 397) (74 x 397) (110 x 397) (130 x 411) N/A 2 tanks in inches 28 x 90 (end to end) N/A N/A (72 x 229) N/A N/A All double-walled tanks come with a generous 30-year Rest limited warranty, as well as an insurance policy worth energy storage products up to $2 million. are safe, reliable, the most durable on the market and they are 4{ uaranteed to last. A-- ROTH QWT ACCESSORIES Roth provides the additional components you'll need to install ( ,.. and operate our oil tanks to their full potential. Du- Fuel plex , outdoorTank Cover(for " .1 l�� ^�''4.}t \.�. '+•!•1��}}�l.. v.� :. 1 �'�"C'\� / r> �rl', \-�/ i. ��(t�1� �u7��r�"`�� .,h]? 1t .� + ��/'il - lei'�► + td A •fir k.:. to/ yrla,/ w. 'I h li,. - A�.��� /'+� ,yti• �. 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LU V M 4-0 \ Cof LO _o - �- a s =2 �► w O Lf� a a - I cz 00 Como N �,.� / f tU to U • �1 Y \4 \y•t �N C«O emu) ` 11 11 'ii's'�'.'-'�—m a'i' 1 l.F i''�?c`';c•p 1 . .Ltt=�"fi".^:r, , t;..i.�..ap,:::.• .i, <O> �• ,�t. •`• 1 / ► _. -• l Ill, �`. , l 111 l . - l Illy:,. ,l/ N �_:' 11 N ; . , "�I A 1���dll)j).)i,4�` a -del)//1(111-"}�l�b�i '•,II''///111_}3�B&,((�$.[/1�II)Illjll� L 9 (141 ni11�111111i!•',�ns�')l !iI11111111i'�'i( a •`�tlll)Ijl(Ill•t-'2+� ��""( .•^,,.�� �Fli � :1�� °��Li A: i Yp V n. .. �f ,raii+'1 �^ r 1:, •• Ar,+} A f'tf •• .,1'9A4�r1i_+V.'Q�.i;,it�#i'w<a���', ��• ,d���.°�A'���% .A• h I Ar�,J ..1{t�. � S,i, '^'�r!'�,ytf�' r�tr'f r+Yff 1. ^ 1' ^. 4v' �. v,W.y � i' � ff�{ � .► �, � \ `a 'i �•. +J' .•. �s s�•Sr ? � � i?i;ttt ii'JK' rr�fl8�m! tk�yry yr�0'xy�,�I, Ir�{pqn, y 5 \ O. O., Y� ;:C�;.,+• t .}�Yk .O E ��'�5 ,t Q'. 4}�{}�Y ti+! f O� "^'i�'�1{VRD• A '"AVM}�hy,., / f ,. �J^ (/�� t'{� �tir (j��`,t,% .�,F��� ,.',M�w J/�\n..,.� lr! ���:��t� of Rv(j�`1ts.� �,iMNFv41t �,p�..p\,_ (v\ •.^t �. \ �� _\\ .... - \.• wt}tY�!'' �-�� r�>r,1..(..... �`\• .vnt.��,v�C•-'� j}/J�' ,A''y�±'3i-'� '�.•�Y.'..wylr.�i'y i ACORE) CERTIFICATE OF LIABILITY INSURANCE r ATE(MM/DD/YYYY) III 12/27/2022 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 CONTACT Arthur J.Gallagher Risk Management Services, Inc. PHONE Matthew Moraski,CISR 4000 Midlantic Drive, Suite 200 e t 18568663252 ac No):856-273-3663 Mount Laurel NJ 08054 E-MAIL ADDRESS: matthew moraski AJG.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A:New York Marine And General Insurance Company 16608 INSURED SINGHOL-02 INSURER 8: Singer Holding Corporation 55 South Main Street,4th Floor INSURER C Port Chester NY 10573 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1284557956 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. IN RI ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PK202200020101 12/31/2022 12/31/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE LK OCCUR PREMISES(Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $2,000,000 X POLICY PRO- a JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY AU202200017525 12/31/2022 12/31/2023 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LAB X OCCUR EX202200001405 12/31/2022 12/31/2023 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 id DED I I RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH)If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Village of Rye Brook Building Department is named as an additional insured with respect to the above General Liability Policy, if required by a written contract executed prior to services performed. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Rye Brook Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 938 King Street Rye Brook NY 10573 AUTHORIZED REPRESENTATIVE Rye ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NEw Workers' )" YORK STATE COMPeIlSa iil CERTIFICATE OF ..:_... Board r.: NYS WORKERS' COMPENSATION INSURANCE COVERAGE 1 a. Legal Name&Address of Insured(use street address only) Ib.Business Telephone Number of Insured ADP TotalSource FL XVII,Inc. 9143455700 5800 Windward Parkway Alpharetta.GA 30005 1 c.NYS Unemployment Insurance Employer UCIF: Registration Number of Insured Singer Holding Corporation 45-04510 9 1 Gateway Plaza 4th Floor Port Chester,NY 10573 1d.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required if coverage is specifically limited to certain locations in New York State,i.e., a Wrap-Up Policy) 133121491 2 Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) New Hampshire Insurance Co. 3b.Policy Number of Entity Listed in Box"1 a" Village of Rye Brook Building Department WC 053440674 NY 938 King Street All worksite employees working for Singer Holding Corporation paid under Rye Brook,NY 10573 ADP TOTALSOURCE,INC's payroll,are covered under the above stated policy. 3c. Policy effective period 07/01/2022 to 07/01/2023 3d.The Proprietor,Partners or Executive Officers are Included.(Only check box if all partners/officers included) all excluded or certain partnerstofficers excluded. El 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"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in boa"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon 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: Michael Price (Print name of aut orized representative or licensed agent of insurance carrier) Approved by: ���ry� �� 23-JuN¢022 (Signature) (Date) Title: CEO North America Telephone Number of authorized representative or licensed agent of insurance carrier: 800 743 8130 Please Note:Only insurance carriers and their licensed agents are authorized to issue Form C-10S.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) Certificate Number: \N.\\cb.ny.gov