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HomeMy WebLinkAboutMP24-049 �yE BR(� 11J t tt4.°ti ov t 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 April 23,2024 7 Bishop LLC 7 Bishop Drive South Rye Brook,New York 10573 Re: 7 Bishop Drive South, Rye Brook,New York 10573 Parcel ID#: 130.77-1-25 This document certifies that the work done under Mechanical Permit #24-049 issued on 4/11/2024 for the removal of an above-ground oil tank has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to �yE BRC�k, 1. cu � 19132 BUILDING DEPARTMENT ^❑,BUILDING INSPECTOR VHSSISTANT 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:- / DATE: PERMIT#! Y 1 Z / O y -1 ISSUED: 1- Z� SECT: 30 7 7 BLOCK: LOT: 25 LOCATION: `J A'�P ^��'' OCCUPANCY: ❑ Violation Noted THE WORK IS... L'PASSED ❑ FAILED 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 I S ❑ FINAL PLUMBING n ❑ CROSS CONNECTION ` ❑ FINAL ❑ OTHER li Y f---� jr a r, - . a v C> a0-4 rq a � Old 0 y a 7 W bQ A� C � v m o I+ ate. N 'C O r�� f T1 7 c70 Z o a s U s h�'� F'+ � `� \ ems-' `° O �{ CN A o w ° L v� w 0 ry v E+ C 0. 4J U 4; O � p o y1 w Z H z o � ° cT can O H Q U E" j. y ' o .5 ^ . .0 W W al o v R C/� ■ 40 W � z N a � o � ci '"` ■ ►-j fl z o o b v p., LO A ZC N ., A � a -0 °a V o OC nn � cu �4CA z W H a � z M a V W a3 o W NQ 0.0 zOC° a � � ■ +� �" O U O a. a C j ��yy W O p 00 z w Q � :" � 'o BUILDING DEP MENT D rD VILLAGE OF RYE OOK APR - 1 2024 938 KING STREET RYE BRoft,NY 10573 (914)939-0668 VILLAGE OF RYE BROCK %vNvN .r%-ebrook.org BUILDING DEPARTMENT Application for Permit to Remove or Abandon Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) ,( 9FOR OFFICE USE ONLY: PERMIT#: /-// Q(!_0 Ll Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees arc non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 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 or Abandonment $185.00 per Tank. 5, Dig Safely New York#(dial 811): 6. Inspection by Building Department for removal or abandonment. 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 or abandon 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 or abandoned in conformance with all applicable Village,County,State&Federal laws,codes, rules and regulations. Indicate Permit Tvoe: Removal(w"•Abandonment( )/Above Ground (V<- Buried in Ground( ) I. Address: 7 Bishop Dr S, Rye Brook, NY 10573 SBL: /30,77 Zone: 9-15 2. Property Owner&Address: 7 Bishop Dr S, Rye Brook, NY 10573 Phone#: Cell#: 914462-2557 email: vitodimatteo4@gmail.com 3. Contractor&Address: New England Environmental Services,lnc. Phone#: Cell#: 914-879-0170 email: Jeff@newenglandinc.com 4. Applicant: Phone#: Cell#: email. 5. Indicate Fuel Type:Fuel Oil j•L.P. Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: Remove one 275 AST from basement 7. Exact Location(s)of each Tank: Basement i 2/21/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Jeff Haig-New England Environmental Services.Inc. 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,attomey,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 to before me this Sworn to before me this 1 day of,20 L� _ day of r ,20 Si nattu�re of—Property y Owner 4a ,A is �7 rv/�II �TLls l t Name of Prope caner P ' e of Appli nt ry Public No !O Wortya yu ubiic,State of New York No.OIME6160063 Qualified in Westchester County] commisslon ExpTres JanuFiry 9,20 This application must be properly completed in its entirety and must include the notanze5 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. Gina M Buttacavoii Notary Public, State of New York Reg. No. 01 BU0003080 Qualified in Westchester County Commission Expires March 20, 202-7 2 2/21/2024 O� o o MAY 2 0 2024 VILLAGE OF RYE BROOK ' 1 BUILDING DEPARTMENT NEW ENGLAND ENVIRONMENTAL SERVICES, INC. 420 S Riverside Ave #305 Croton NY 10520 (855) 245-9990 May 13, 2024 Village of Rye Brook 938 King Street Rye Brook NY 10573 Re: Dimatteo 7 Bishop Dr S Rye Brook, NY 10573 We removed a 330 AST from the basement at the above address. The tank was cut and cleaned by us, and there was no visible contamination. The tank was taken to Brookfield in Montrose. Copies of analytical data are attached. Thank you for your time, �i%�-e Jeff Haig NEES President Rill of Lading EGC Environmental services, Inc P.O. Box 624 North Branford, CT 06471 a (203) 395-5418 invoice ts: t A� Date: Customer: Bill To: Name: Name: Address: ' t`,f4 D) Address: City/State: r4y +iSOO City/State: Telephone: _ Telephone: Contact: Contact: Customer ill# Purchase order# Manifest# Driver Qt Units Description Unit Pr Total Gallons Waste Oil CRO? c. Gallons Waste Fuel oil Tank Bottoms CRO2 Gallons Waste Water CR04 PH Gallons Waste Antifreeze'water CRO4 F i Gallons Fuel oii,Combustible liquid,UN1993 r Gallons RQ Gasoline,Benzene 3,UN 1203 Gallons 1N'aste tiVater Soluble CR03 [ ,y j Sediment Charge I Tank Cleaning/Tank ?MP Out Waste Gasoline Tams bottoms&Water CR04 jHours Trucking Q-4000 Dexsil Chlorinated Solvent Test (sl Results PP Baseline Testing Done:Yes or No(Records on file)I Uil Filter Removal Parts Washer SerVice t Customer certifies and represents that the materials provided to EGC En+ironmental tier ices, Inc,hereunder ha.a not been mixed,combined,or others+ise blended in any 4u4n1i1% With any Subtotal 3"` materials containing pol%chlorinated hiphen0s(PCB),Chlorinated lyents ur any other material defined as a Hazardous Waste under applicable la»s,including but not lsn"tfd In 40 CF'R Fart Fuel Stir Charge 261. Customer agrees to indemnify and hold EGC Environmental 4er,,-ices.Inc., harmless for any damages,costs,attorney's fees,etc.arising out or or in any N•8)'related 1(,r t),,,,h of the Tax above warranty by the customer. Hal Due dy DateCustomer Signature Print Name wl ir v A j4tt�)! ✓;:.�`J..�'1='• -_►L��'jay( ..er` ��`'�l_i• � �� �.'''i' wadi�a'� 1 s ',� ;r"��;• .•+�' • Y L E •_� ? '� ..' f u c u > 4tCO r Lu r ul c z -- _ S JJ v w w 0 f O CL C _ O V C ci L w w = v '�`' • C n.. Z O t 3: V v t/) I .� (7 C UJ F a Z v 03 .. v { ° eqg, p C N ! y iLMMM M i r �� scxYxz�ncxYvcx . �e -I,*., �:-LF*' •t�I" l ` '+k lT etO_Im Ai/ • '� '1J;i. 4 `+ ,.. AC")?"® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/29/2024 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 endorsemen s. PRODUCER NAME: R104 AR D INSLEY FREE FROM RISK LLC Nc No E;d: 914-51TL950R AIC,No):FAX �-217-1 >v0 18GREATPLAIN RDSTE202 ADDRESS: RICHARWw,FREE FRO MRISKLLC.COM DAN BURY Cr 06810 INSURER(S)AFFORDING COVERAGE NAIC p INSURER A: AXIS Surplus Insurance Company INSURED INSURER B: Progressl w Commercial NEW ENC3.AND ENVIRONMENTAL SERVICES INC INSURERC: 420S RIVERSIDE AV EA305 INSURER D: C ROT ON NY 10520 INSURERE: INSURER F: COVERAGES CERTIFICATE 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 SI-OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS rLTR TYPE OF INSURANCE INSO WVD POLICY NUMBER (Mill (MWDDIYYYY) LIMBSx COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,P0,000CLAIMS-MADE OCCUR PREMSES Ea occurrence) $ 501)00 MED EXP(Any one person) $ I0A00 x EMP23003956-01 12/05/2023 12/052024 PERSONAL&ADV!NJURY $ 1,000,000 GENT AGGREGATE OMIT APPLIES PER- GENERAL AGGREGATE $ 2,(1110,000 v POLICY �PROJECT LOC PRODUCTS-COMPIOP AGG $ 2,(1)0,000 OTHER Pollution Liability $ 1,000,000 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ 1,(D0,000 ANY AUTO BODILY INJURY(Per person) $ B OWNED y SCHEDULED (1`S31-,0 10A020'' IOLIO/2024 BODILY INJURY(Per accident) $ AUTOS ONLY I� AUTOS HIRED y NON-OWNED PROP= $ AUTOS ONLY nAUTOS ONLY (Per accident) _ _ _ E UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ RETENTION$DED E _ KERS COMPENSATION TUTE R $ AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE N/A E.L.EACH ACCIDENT i FFICFR/MF,MBFR FXCI()DFD7 L1 E.L.DISEASE-EA EMPLOYEE $ Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ A Pr.fessior>al Liabllin X EMP23(*3956-01 12/05/2023 l2/0512024 Each Claim 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK NY 10573 Ce rli fica to hdder is also listed as additional inure cl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF RYE BROOK THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 938 KING STREET ACCORDANCE WITH THE POLICY PROVISIONS. RYE BROOK NY 10573 AUTHORIZED REPRESENTATIVE © 88-2015 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 a a A A A A A A 472242944 NEW ENGLAND ENVIRONMENTAL SERVICES INC 420 S RIVERSIDE AVENUE 4305 CROTON NY 10520 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER NEW ENGLAND ENVIRONMENTAL SERVICES VILLAGE OF RYE BROOK INC 938 KING STREET 420 S RIVERSIDE AVENUE#305 RYE BROOK NY 10573 CROTON NY 10520 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2348 994-1 640183 11/28/2023 TO 11/28/2024 3/29/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2348 994-1, 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 JEFF HAIG VICE PRESIDENT JAMIE HAIG NEW ENGLAND ENVIROMENTAL SERVICES 1 2OF2 THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER Al%O:;"dTS YAWL PrAi- 1": WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. 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 SU NCE FUND 7 �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 950048045 U-26.3