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HomeMy WebLinkAboutMP24-050 QR C L LC+Cv o� Q .r+4ctN,Y V 'C 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 May 7,2024 Vipin Thomas Kovoor&Merin Thomas Kovoor 32 Valley Terrace Rye Brook,New York 10573 Re: 32 Valley Terrace, Rve Brook,New York 10573 Parcel ID#: 135.59-1-65 This document certifies that the work done under Mechanical Permit #24-050 issued on 4/12/2024 for the removal of an above-ground oil tank has been satisfactorily completed. Sincerely, Steven E. Fews Building& Fire Inspector /to �E BRnv� BUILDING DEPARTMENT /1"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 - - - - - - - - - - - - - - - - - - - - � ! 7 �.� ADDRESS:- DATE: 51 PERMIT# t�1YL 1 �" ISSUED: SECT: BLOCK: LOT: LOCATION: � a �r• 1''�3 t�',�/ OCCUPANCY: ❑ 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 ❑ L.P. Gas % .ram'" FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER p o L w o N N a � � ❑ W P,�, Ana '=' C�.1.i � w � � � Z � a � acd M Al o � v - L6 I ono Z a 2p en 'T� OLe-) ° w O Q Q w O M � «. 0 � �+ o a Q w mp¢ V 4-4 v ° ° vy z ° w a ° E V O z Vz � ° r Q en C7 ti v > � G � 6 r-1-4 ° ° cvrjU z 6 , c�° .0o � � - z o rc, W W o G _ z � = w ono NS � :c •y � O V U O I 0 > „ O o C c u U W E. , " .a •� Ogg ago ag BUILDING DEPARTMENT FR C [EiiWLE 3D VILLAGE OF RYE BROOK 938 LONG STREET RYE BRdlC ,W 10573 APR 1 22024 (914)939-064f�' L�— www.rvebrook.ora VILLAGE OF RYE BROOK 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) FOR OFFICE USE ONLY: PERMIT#: /—/ � ` �J 0 Approval Date: R 1 HP-) Permit Fee: $ Approval Signature: Other: Disapproved: m (fees are non-refundable) ************************tk***iliF*****************:t*x*****;l-k******i•ir*******k***ir k*****ak*�***!****t**•k;t*ii* DO NOT START WORK or(:ONS"I R U(TION UN I ILA PLRNl1-1 HAS BEEN ISSUED B1 TIIE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED «1THOUT A PERMIT IS 120% 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 81 1): 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 Type: Removal (�•Abandonment ( )/Above Ground VT-Buried in Ground( ) I. Address: 32 Valley Terrace, Rye Brook NY 10573 SBLJ�r J—t�f—(pS zone: 2. Property Owner&Address: Vipin Kovoor-32 Valley Terrace, Rye Brook NY 10573 Phone#: Cell#: 914-420-3669 email: vipin.kovoor@gmail.com 3. Contractor&Address: New England Environmental Services,lnc. Phone#: Cell#: 914-879-0170 email: Leff@newenglandinc.com 4. Applicant: Same as contractor Phone#: Cell#: email: 5. Indicate Fuel Type: Fuel Oily•L.P. Gas( •Gasoline( )•Other( ): 6. Number and Capacity of each Tank: One 33 U -eAJaVQ 7. Exact Location(s)of each Tank: AST in basement a 2/21/2024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: .left Haig-New England Environmental Servlces,lnc,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 to before me this Sworn to before me this day of 20 _ day of ( ,20 � � r Signa re of Property Owner ignat c pplicant P 14 o V 00 r P ' ame of Property Own Print ame of ApplicanJt'y� Notary Public ^* public,State of New York Notary P AE ORY M.RIVERA Jo.OIME6160063 Nebry public,State of New York ied in Westchester County No.01 RIGMI 398 pion Expires January 29,20_ Qualified In Westchester County This application must be properly completed in its entirety and musC rwnlsslon EglmsUpt�¢mber 26,201 signature(s) of the legal owner(s) of the subject property, and the applicant of record in the ,,paces 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 2/21/2024 t pL �� � MAY 2 0 2024 • VILLAGE OF RYE BROOK ` 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: Kovoor 32 Valley Terrace 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%� Jeff Haig NEES President r EGEnvironmental Services, Inc Bill of Lading F.O. Box 624 North Branford, CT 06471 (203) 395-5418 Invoice#: e)7 5 Date: Customer: Bill To: �,_., F�• t� , ,�,,_�,,��._ � Name: + 'a a3 " Address: Name: .- Address: i1 r 5 4 Cit)'iState: �• `t'l City/State: � Telephone- Telephone: Contact: Contact: Customer ID# Purchase Order# Manifest tY Driver Qn• Units Description Unit Pr Total Gallons Waste Oil CR02 Gallons Waste Fuel Oil Tank Bottoms CR02 Gallons Waste Water CRO4 PH Gallons NVaste Antifreeze/Water CRO4 `• F Gallons Fuel oil,Combustible liquid,tJT,1993 Gallons RQ Gasoline,Benzene 3,17N 1 b3 it Gallons Waste Water Soluble CR03 Sediment Charge I Tank Cleaning/Tank Pump Out Waste Gasoline Tank bottoms&Water CRO4 Hours Trucking 1 5•.,, 4� u.v Q-40M Dexsil Chlorinated Solvent Test(s)Results PPM Baseline Testing Done:Yes or No(Records on file) Oil Filter Removal Pans Washer Service Customer certifies and represents that the materials provided to EGC Em ironmental Services. Inc hereunder have not been mixed,combined,or otherwise blended in any quantity with any Subtotal materials containing polychlorinated biphenvis(PCB),Chlorinate4d Solvents or any other material defined as a Hazardous iVaste under applicable lams,including but not limited to 40 CFR Part Fuel Sur Charge 261• Customer agrees to indemnify and hold EGC Environmental Services,Inc.,harmless for aa)damages.costs,attornev's fees.etc.arising out of or in any w•av related to a breach of the Tax above warrant,by the customer. Bal Due Customer Signature Print,Name Date ch I O ice © N `t CIA y9. LO � to N 0 o I � lrlr c7 o G 4) uLO o O o (Y) C) C CD CD CD O it +�+ Ls p �- Q _� + a) ai o co z co I f 0 it w i w p CD > > o O n \ (D z Q Cq 0 Cq W 0 ' fl N _� O � C < (13 -- -C-- T- V VJ o T- r Q 0Y O = C3 N 0 o E-- 0 0 w N LL' �- a E �, 0 R C v P 3u � J � U cC U �f � ' }� may, M i �+5+ � f ti M 7 r H ti �fi 'L� �.�����7+y���ll � �(Ili�f $�:���I3�+ s � {�•�� /,� ...�� 1 t T � r y L t V W O c t C Q�u cn d > t. Z CC Q' r x Ge �titi C ; O u "•alp / t C Z M . to PTA WY � t••:�` b is G u = 1 a s � N v w t� ,4y 1 ..�.X,C'+KX7GZ7LT.xXX7iltii `440a :1 r fLti ACO 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: RI(IiARDINSLEY FAX FREE FROM RISKLLC PHONE A1C No,End), 914-500-9508 A/C,No 83.1-217-17D0 18 GREAT PLAIN RDSTE202 ADDRESS: RICHARU(?FREE FRO MRISKLLC.COM DAN BURY Cr 06810 INSURER(S)AFFORDING COVERAGE NAIC R INSURER A: AXIS Surplus Insurance Con an INSURED INSURER B: Progressl w Commercial NEW ENGL AND ENV IRONM ENTAIL SERVICES INC INSURERC: 420S Rl VERSI DE AV E#305 INSURER D: C ROT ON NY 10520 INSURER E: 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 LTR TYPE OF INSURANCE INSD WV0 POLICY NUMBER (MM/DDNYYY) (MM,ODNYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ I,W0,000 CLAIMS-MADE FxI OCCUR PREMISES(Ea occurrence) $ 50,000 MED FXP(Any one person) S I OD00 A X EMP23003956-01 12/05/2023 12/052024 PERSONAL&ADv,NJURY $ 1,070,000 GEN'L AGGREGATE I]MIT APPLIES PER GENERAL AGGREGATE S 2,(1)0,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG E 2,0J0,000 I� OTHER Pollution Liability S 1,000,000 AUTOMOBILE LIABILITY 770MBlIqED-STSIGLE LIMIT (Ea accodenq $ I'M0,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ l AUTOS ONLY X AUT0.S (is At 0,y 10A0.2OZ 10/30/2024 HIRED �/ NON-OWNED - $ AUTOS ONLY /� AUTOS ONLY (Per accidena UMBRELLA LIAB OCCUR EACH OCCURRENCE E EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STATUTE ER TF ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT 11 FFICFR/MFMBFR FXCI 0DFD7 Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS beiuw E-L DISEASE-POLICY_IMIT E A PrcPessiotal Irah17in Each Claim 1,000,000 FJ�iP23 003956-01 12105/2023 12/05.2024 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached A more space Is required) VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK NY 10573 Cerrficate 6dderis also listed as additional insured 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 i� 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 472242944 _ NEW ENGLAND ENVIRONMENTAL SERVICES INC 0 420 S RIVERSIDE AVENUE#305 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://V11WW.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 RECO`dC:D Ak ntim-rS %A1E PAlc 1m 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 STATESUR NCE FUND �/ DI RECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 950048045 U-26.3