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HomeMy WebLinkAboutMP24-011 DR tt4 +.°u Jvv t Cat.. GG 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 Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE February 21,2024 Miguel Goldfeld&Veronica Sicorsky 59 Talcott Road Rye Brook,New York 10573 Re: 59 Talcott Road, Rye Brook,New York 10573 Parcel ID#: 135.50-1-68 This document certifies that the work done under Mechanical Permit #24-011 issued on 2/7/2024 for the removal of two above-ground oil tanks and the installation of two new above-ground oil tanks have been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE BRC�k. • 1982 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 ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : S ! f 'J T T \l L. DATE: PERMIT# ISSUED: %' Z T SECT: /3.5-, sb BLOCK: i LOT: L LOCATION: i�c- r {'7 OCCUPANCY: c=- / ❑ Violation Noted THE WORK IS... 0 ' PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION❑ Natural Gas ��n U y�� �W 4 . = • /_ C]�'FUEL TANK , / !�✓ / /SSU� El FIRE SPRINKLER (�f Q J�l /mil /� / �V� /y yV f� ❑ FINAL PLUMBING �)L OS_ Li4 E JF ❑ CROSS CONNECTION �-- ❑ FINAL ❑ OTHER * - BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q 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 : -I `rA L L 0 TT '✓ DATE: L PERMIT# 2 - ISSUED: "T 1 SECT: BLOCK: / LOT: LOCATION: 7 OCCUPANCY: G�� ❑ Violation Noted THE WORK IS... [PASSED ❑ FAILED / REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas r/V S TA G �w N-F ki 2,20 ❑ FUEL TANK �� cLON � • /S . .1 �T`�/ "'�S��I/ � /Yl�/V� ❑ FIRE SPRINKLER 1 ❑ FINAL PLUMBING IJ n D/L,` 2 A�\ Wi1 7E� ❑ CROSS CONNECTION /S f� ❑ FINAL A; ❑ OTHER S _ a = � w = ' N N N N '" c a 1^ r a ! F+ D \ N M Oo w INx � p W a pp..� Cn >C L W � w 1 C/� � 0 r�+ 00 U Q 07 O a fS" °� �• a o W log s W co W F�1 cn �° au v to _ caIz F V q ~ A � a. y GJ = ^ z W O A w 0 oa V yR4 l 11 `+) F � � L+ M ►+w W 04 {n z z W U �; O ° V 7 Q 0.1 p 0 - V t W a a. f� W � W p z CWIy w � Q ° a M--�I oo `� ~ O a A W x ° QC1 1�1 C Q 0 W p C o G� z -A C. a � _ BUIL DEPARTMENT L U��J VIL E OF RYE BROOK 9DD 3H KING ET RYE BptooK,NY 10573 i FEB — 7 M4 (914)09 9 �,939-5801 N LO�--, r I VILLAGE OF RYE BROOK 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#:. `y `0 1 1 2� Approval Date: �' �`� Permit Fee: $ 7-40 Approval Signature: V 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: $185.00 per Tank. S. Dig Safely New York#(dial 81 1): N/A -Aboveground Storage Tanks 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, 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 Type: Installation (x)• Removal(X)• Abandonment( )/Above Ground (30• Buried in Ground( ) 1. Address: 59 Talcott Road SBL: 135.50-1-68 Zone: 2. Property Owner&Address: Veronica Sicorski 59 Talcott Road,Rye Brook Phone#: 914426-9466 Cell#: email: verosico0l@gmaii.com 3. Contractor&Address: Innov8tive Environmental 392 Columbus Avenue Valhalla NY 10595 Phone#: 914-449-6608 Cell#: email: service@,innov8enviro.com 4. Applicant: Innov8tive Environmental Phone#: 914-449-6608 Cell#: email: service innov8enviro.com 5. Indicate Fuel Type: Fuel Oil(T)• L.P. Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: Removal of(2)330 Gal ASTs and Installation of(2)330 Gal ASTs in same location 7. Exact Location(s)of each Tank: Basement of the home 1 6/1/2020 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Donnie Feeney ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the Contractor for the legal owner and is duly authorized to make and file this application.(indicate architect,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 Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn before me this W^ Sworn to before me this 0�2 day of 20 U day Qf O.y ,20� Si o e Owner Signature of Applicant Donnie Feeney ZintName XPrope Owner t Name of Applic Notary Public i40F NEE03, R Notary MINE MEYER Notary Public,St New York Notary Public,State of New York Lic.No.o10833 Lic.No.01 ME6130833 quaiihod in Weser Coun qualf ed in Westchester Coun— Commission Bxpirss July 25, Commission Expiras July 25, 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. 2 6/l/2020 -Ar S Y p U O � m � T Y (N O cq- fJ 0 70 o 00 0 o ' O M00 U o v v L L; N v U L 6J li> Y E C N Ln O > Cl) L Q O LU } j E Z Y 00 O — > u rn O N L M > Standard n Standard oil tank with strong welded lap joints `l SAFETY Bottom outlet configuration allows(of natural elimination of water build up from condensation DUIWIUTY Electrostatic powder-coated paint Made of robust material PEACE OF MIND 10 years against manufacturing defects('See warranty certificate for details.) Contractor friendly,trouble-free installation DimensionsProduct Ce Model 209101 120 Vertical 12 47"/23'/30" 170 208101 138 Vertical 12 44'/27"130' 160 208601 138 Horizontal 12 27'/44'/30' 160 207101 220 Stubbies/Vertical 12 44"127"/48" 220 203201 G 230 Thin I Vertical grey 12 44'/22'160" 235 203701G 230 Thin/Horizontal grey 12 22"/44'/60' 235 202201 240 Narrow/Vertical 11 47'123'/60" 265 202701 240 Narrow/Horizontal 12 23'/47'/60" 265 204201 275 Verticaf 12 44"/27'/60" 255 204701 275 Horizontal 12 27'/44'160" 255 211201 275 Vertical 10 44"127'/60" 330 211701 275 Horizontal 10 27"/44'/60" 330 205201 330 Vertical 11 44"/27"/72" 290 205701 330 Horizontal 12 27" 44'/72' 290 D [EC EME 3 { FEB - 8 2024 1 N N OVA, �T VILLAGE OF RYE BROOK BUILDING DEPARTMENT P ENVIRONMENTAL SERVICES INC . February 8, 2024 Village of Rye Brook Building Department 938 King Street Rye Brook, NY 10573 RE: Veronica Sicorsky 59 Talcott Rd Rye Brook NY M P-24-011 To Whom It May Concern, This letter is regarding the work performed at 59 Talcott, Rye Brook, New York in accordance with permit#MP 24-011. Innov8tive Environmental Services (IES)was contracted by Veronica Sicorsky to remove(2) 330 Gal Aboveground Storage Tank (AST)from the basement of the home and install (2) 330 gal AST's in the same location as the removal. IES began the removal process February 7, 2024. IES pumped 60 gallons of waste oil and sludge out of the aboveground tank. A liquid waste manifest is attached for your viewing.The AST was then cut and cleaned in accordance with DEC regulations.The tank was found to be free of any breaches or contaminants. An inspection was performed by the Village of Rye Brook building inspector, where it was determined that the scope of work was completed in accordance with the current regulations.The tank was then removed from the premises and recycled at M. Miller's Scrap Iron & Metal Co., Inc., Portchester, NY. A scrap tank ticket is attached for your viewing. At this time, IES is requesting closure of permit #MP-24-011. Please advise if any additional information is required. Thank you, _ Donnie Feeney Innov8tive Environmental Services Innov8tive Environmental Services Inc. 392 Columbus Avenue, Valhalla NY 10595 service(a-)_innov8enviro.com 1 (914) 449-6608 www.innov8enviro.com NON-HAZARDOUS WASTE MANIFEST Please print or type (Form designed for use on elite(12 Ditch)typewriter) ge NON-HAZARDOUS 1.Generator's US EPA 10 No. Manifest 2.Pa Document No. WASTE MANIFEST 3.Generator's Name and Mailing Address e.Y'6Yl i Cr, SgTa�ce�R..�L 4.Generator's Phone 5.Transporter 1 Company Name 6. US EPA ID Number A.State Transporters ID Innov8tive Environmental Services N Y R 0 0 0 2 3 9 2 1 0 B.Transporter 1 Phone 914-449-6608 7.Transporter 2 Company Name A. US EPA ID Number C.State Transporter's ID D.Transporter 2 Phone 9.Designated Facility Name and Site Address 10. US EPA ID Number E.Slate Facility's ID Clean Water of New York N Y 0 0 0 0 9 6 8 5 4 5 3249 Richmond Terrace F.Facility's Phone Staten Island, New York 718-981-4600 11.WASTE DESCRIPTION 12. Containers 13. 14. Total Unit No. Type Quantity Wt Nol. a. Non RCRA, Non DOT liquid (Oily Water) 1 T T \} Gallon G b. - E N E R e. A T O W JR1 d. I— N G.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Above 0 0 15.Special Handling Instructions and Additional Information Z Z 16.GENERATOR'S CERTIFICATION:I hereby certify that the contents of this shipment are fully and accurately described and are In all respects in proper condition for transport.The materials described on this manifest are not subject to federal hazardous waste regulations. Date Printed/Typed Name ature Month Day Year Donald Feeney - As Agent for 2 7 Z T 17.Transporter 1 Acknowledgement of Receipt of Materials Date R A Printed/Typed Name Signature Month Day Year N Sean Penelle S P 0 18.Transporter 2 Acknowledgement of Receipt of Materials Date R Printed/Typed ed Name Signature T YP 9 Month Day Year E R F 19.Discrepancy Indication Space A C 1 20.Facility Owner or Operator:Certification of receipt cf the waste materials covered by this manifest,except as noted in item 19. L I Date T Printed/Typed Name Signature Month Day Year Y Copyright©2006,ShipMate,Inc.V,All Rights Reserved (310)370-3600 www.shipmate.com PAYMENT RECEIPT Brookfield Resource Manageme t 100 Lamont Street Elmsford, NY 10523 914-592-5250 Receipt:1845524 Date•2/8/202 4 Customer:69802 Time:2:22,42 PM INNOVATIVE ENVIRONMENTAL 392 COLUMBUS AVE VALHALLA, NY 10595 ID Number: Ticket:1899694 Weigh In:2/8/2024 2:13:19 PM Operator:Romy C Weigh Out:2/8/2024 2:22.39 PM Commodity Gross Tare Net Price TOTAL$ Tanks 12.660 11,700 960 2.2300/CW 21.41 ------------------------------------------------------------------------ Ticket Total: 21.41 No.of Tickets:1 EZCash Paid: $21.00 Payment Method:EZCash Round Am[: ($0.41) Total Paid: $21. 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(1 lfst P° Volt«s)► 1 1 i' 11 - II 1Op841+ / llQ,p+d 11 11 a //0 8j11" `, �1AOOe� a�asfy�ny. t10pOpl' It�x 3w%SDI.:�Ie80A00Ap �. 6co�'ts.�t1�00o0e11 il80AOA081 ...q}:.A 10•Q °pp> :1 tf,-r. �.e/I 1 1! �'i�y it r'. A _ A ! .b A...-.A ,4.7. d V �yf t711 E�1 t S 't},fi' 1t,�rf'•.ti e x•� b` A -ilt}ty •'� A ty.. .'°A+�i�d'P ..rr��}, .�•a}'n 7A�6.�%'�J b7l�?� 1iS4�!.lr s:�t '�"•`'..ti 'Vi} t��'y�� -'j� NStp��t$ •��� .}•�5 � - •,}e}}Ow lit MEW ?2, x2}�7`.v AT:ss ( w�l7tir tkw11's3 - titc?wTCtr .kfea "r <F/dw Its�-_. VI!�w� ,. �.} DATE(MM/DD/YYYY) ACORD® CERTIFICATE OF LIABILITY INSURANCE 2/8/2023 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 Mt Pleasant Capacity PHONE Evita Dermanis FAX P.O. Box 1689 •914-205-7682 Afc No):914-205-7682 Pearl River NY 10965 ADDRESS: E*Ata.Dermanis@mtpcap.com INSURE S AFFORDING COVERAGE NAIC0 INSURER A:Century Surety Company 36951 INSURED INNOENVt INSURER B:Progressive Casualty Insurance Company 24260 Innov8tive Environmental Services Inc. 392 Columbus Ave INSURERC: Valhalla NY 10595 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:16166041 REVIS!ON 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. LNTR TYPE OF INSURANCE ADDUSUBR POLICY NUMBER MM/DD/YYYY) (MWDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CCP1108511 2/14/2023 2/14/2024 EACH OCCURRENCE $1.000,000 CLAIMS-MADE OCCUR DAMAGE T RENTED PREMISES Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY JEC PRO- LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ B AUTOMOBILE LIABILITY 016663983 1/15/2023 1/15/2024 COMBINED Ea ccident SINGLE LIMIT $1,000,000 a ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANYPROPMETORIPARTNERIEXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFF ICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $ A Pollution Liability CCP1108511 2/14/2023 2/14/2024 EachCleim 2,000,000 Aggregate 2.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached 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 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD NYSIF New York State Insurance Fund PO Box 66699,Albany, NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE �. ''V ■0 ^ ^^^^^ 824703808 MT PLEASANT CAPACITY AGENCY ry , '��■, 1 BLUE HILL PLAZA STE 1689 r' PEARL RIVER NY 10965 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOI..DER INNOV8TIVE ENVIRONMENTAL VILLAGE OF RYE BROOK SERVICES INC 938 KING STREET 392 COLUMBUS AVENUE RYE BROOK NY 10573 VALHALLA NY 10595 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2455 047-7 772976 10/02/2023 TO 10/02/2024 10/2/2023 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2455 047-7, 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 DONALD FEENEY VICE PRESIDENT FRANK MORACO INNOV8TIVE ENVIRONMENTAL SERVICES 20F2 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 STATESUR NCE FUND �/ DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 522201643 U-26.3