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HomeMy WebLinkAboutMP24-079 BRn Lb Lb � ti t wu JJ V �t°npv�y'J 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 July 2,2024 James Rodriguez&Tami Rodriguez 66 Rock Ridge Drive Rye Brook,New York 10573 Re: 66 Rock Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 135.36-1-18 This document certifies that the work done under Mechanical Permit #24-079 issued on 6/13/2024 for the installation of a temporary above-ground oil tank has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE BRCbk 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 : (D V x0c Imo- i ��L( ✓lI 1 ✓" DATE: ? Z PERMIT# /�// �� G 7 ! ISSUED: -!y"Z`/ SECT: BLOCK: LOT: 2U LOCATION: (� S OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... 0 ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION �. ❑ NATURAL GAS J 7, ✓L i l ❑ L.P. GAS 1 ti /"v Al FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION v y ` /U ❑ FINAL ❑ OTHER 7 N C a = O N h W Gi - � y ; 'b To wo CA 14 , Op � _ p W a � v � � n � � o b �,�B o o x = wLO � v LO ©; oar ; o w 00 w ,r w � o � ° _= r � a 04 coW w ~J w UZoz Z 00 , . ~ � � w ��..� U ►� E•+ '�' 7 �" A as . N w � � v, c)U. v a ,, ►.r Ix - a VE Z V z a w O -qd :� ' �1 aa v A z 0. ,� 0 BUILDING DEPARTMENT ECMWEP VILLAGE OF RYE BROOK R JUN 13 2024 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK D.r=, yAI1•v4k,ur BUILDING DEPARTMENT Application for Permit to 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: G— L 0 2.q Permit Fee: $ Approval Signature: y.... Other: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRL CTION UNTIL A PER NI IT [IAS BEEN ISSUED 1131'THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COS"I 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: Installation: S 185.00 per Tank. 5. Dig Safely New York#(dial S 1 1): 6. Inspection by Building Department for installation. 7. Submit all Manifests& Reports(if applicable, after work has been completed). S. 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 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 installed in conformance with all applicable Village,County,State& Federal laws,codes,rules and regulations. Indicate Permit Type: Above Ground jam• Buried in Grounr. 1. Address: 66 Rock Ridge Dr SBL: 135.36-1-18 Zone: 2. Property Owner&Address: Tami Rodriguez 66 Rock Ridge Dr Phone#: Cell#: 917-576-5954 email: tamihrod@gmail.com 3. Contractor&Address: Innov8tive Environmental Services 392 Columbus Avenue Valhalla, NY 10595 Phone#: 914-449-6608 Cell#: email: service@innov8enviro.com 4. Applicant: Innov8tive Environmental Services 392 Columbus Avenue Valhalla, NY 10595 Phone#: 914-449-6608 Cell#: email: service@innov8enviro.com 5. Indicate Fuel Type:Fuel Oil(,�•L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: Installation of 275 Gal Temp Tank 7. Exact Location(s)of each Tank: �\X 51 h 10/30/2023 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. Swom before me this Sworn t before me this �Z" day of Q —,20 2 da% of 20 _ Signature of Property Owner Si nature of Applicant Tami Rodriguez Donnie Feeney %in(%Name-bfPrope Owner Prfillt Name ofApplican � Ujuk� - Notary Public MRVlR Notary NpRINE MEYER Nate p lic,State of New York �of a York L .of MEB130833 Notary public, Qualifie Westchester Coun Lic Na.01 ME613 83 u Commission Expires July 25, pual'�ied in Westcheste ires July 25,20 This application must be properly completed in its entirety and must incl m 10n rizec 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 l 0/30/2023 Standard n Standard oil tank with strong welded lap joints `/l SAFETY DURABILITY PEACE OF MIND tons Vert�c.. 47"/23"!30" 170 Verncal 11 44'/27'/30' 160 138 Horizontal 12 27-/44'/30' 160 220 stubbre<I V, 44" 27'1 48" 220 230 Thin/Vert,- 12 44'!22'160' 235 2 3:- Thin/Horizontal grey 12 22'/44"/60' 235 740 Narrow/Verucat 47'/23" 60" 265 240 Narrow/Horizontal 12 23'147'!60" 265 204201 275 V� ` 204701 275 Horizontal 12 27"/44"/60' 255 211701 275 10 44"127" 60' 330 44 72" 290 27'/44"/72' 290 o` m o� v O p Y p U O CO Ix N i CEO 2 OJ v N O n 3 I � 0 L U 00 Q O O > 0 C_ O Cl) > � N CO i 1 S v s I N v v 3 = > Ln 0) o Q � LUJ > cu � Z � o - > U � O ni = pl 70 m > A A �•10 +�1'F✓ O � � 1 FFQ�Q �K ) `, d -O `n •eC N 1 t -F O O �p y O X N ,Y h a> O :. / w ` ^�r > O «�O. LLTJ FBI • (r WLLJ LOC.J y � 4-J, CJ �•.+ J w O O@Ct10n LU D «. ¢ zi G cz. 4 \ W" w ch two o z c. > o ^ v C J) J y z U a) O / 3 ip goO C. (� y U s U , 11-V6411�j ,:t i�'�A�`-"�� � +��A�lf.•`�Mi�' +��^ ��.SY�t�/�!� fly�{�l�j y�J�M �Ili� ""s' �' ihM ^�•1tV 'hV 1 ` F d __/ �.�S DATE(MMIDDIYYYY) A CC CERTIFICATE OF LIABILITY INSURANCE 2/16/2024 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 endorsement(s). PRODUCER CONTACT NAME: EVlta Grande _ Mt Pleasant Capacity PHONE FAX P.O. Box 1689 • 914-205-7682 (A/C,No):914-205-7682 Pearl River NY 10965 ADDRESS: Evita-Grande@mtpcap.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Century Surety Company 36951 INSURED INNOENVI 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:1933147098 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. INSR I ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY CCP1193364 2/14/2024 2/14/2025 EACH OCCURRENCE $1,000,000DAMAGE TO RENTED _ CLAIMS-MADE FKI OCCUR 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 JE O- LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ AUTOMOBILE LIABILITY 01666398 1/15/2024 1/15/2025 COMBINED SINGLE LIMIT $1.000,000 Ea accident 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 1 1 RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Pollution Liability CCP1193364 2/14/2024 2/14/2025 Each Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 AUTHORIZED REPRESENTATIVE Rye Brook, NY 10573 n // 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 �. fTr ^^^^^^ 824703808 MT PLEASANT CAPACITY AGENCY 1 BLUE HILL PLAZA STE 1689 ❑F PEARL RIVER NY 10965 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER 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 STAT SUR NCE FUND 7 �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 522201643 U-26.3