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HomeMy WebLinkAboutMP24-074 C�CtC � VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J.Bradbury www.tyebrookny.gov TRUSTEES BUILDING & FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE July 31,2024 The Revocable Trust of Elyse Echtman&Daniel Berger Elyse Echtman&Daniel Berger,Co-Trustees 69 Rock Ridge Drive Rye Brook,New York 10573 Re: 69 Rock Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 135.36-1-1 As per the Certification letter from Innov8tive Environmental Services Inc. dated July 31, 2024, the removal of an above-ground oil tank under Mechanical Permit #24-074 issued on 6/12/2024 has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �E BRC�v� 1. 1982 BUILDING DEPARTMENT WILDING 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 : dL� i ^�..�e l ✓c. DATE: to l V Z`� PERMIT# rn P 2 y- y-7 9 ISSUED: -I - z /SECT: I3Sr -3(o BLOCK: ; LOT:- LOCATION: c s' 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 IR PY-no V c 0 ❑ L.P. GAS Q' FUEL TANK 0 Of ❑ FIRE SPRINKLER ❑ FINAL PLUMBING NL L w�z L Cd�P L Lp, Ic • i ss U� ❑ CROSS CONNECTION n ^ I ❑ FINAL I 'F I C C r` ct<" we K(�P Ll� 1 C(/LQ ❑ OTHER OTHER Q�J2�r 7 � w U cn W � a Lei Z a v V. Q ° W , c :� b 'u •� Q W � r�i cr rA op cc F; U � -d � dAf' a' z g �" � .b L WO Z w W v p A p -"o v aCi UJ a GO a W \ n > , CY zZ vw u 0Cc —4 A a3 u W H W C7 o W x a ° ° U - ° N v u. O 'v v v OH °z o zy � _ W c, v. � b , BUILDING T) MENT 21ECEWED Viz A E OF RY OOK 938 KING ET RYE$R ,NY 10573 U - 4 2024 -0 -� VILLAGE OF RYE BROOK BUILDING DEPARTMENT Application for Permit to Remove or Abandon Fuel Storage Tank (*Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: Approval Date: (�\ � Permit Fee:$ V Approval Signature: Other: Disapproved: (fees are 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#C105.2 or Form # U26.3 /or NY State Workers Compensation Waiver) 4.Fee per Tank: Removal or Abandonment S 185.00 per Tank. 5. Dig Safely New York#(dial 81 1): NIAAboveground-rank 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, 2j4 ,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: Removal1treAbandonment( )/Above Ground (V• Buried in Ground ( ) 1. Address: 69 Rock Ridge Dr SBL: 135.36-1-1 Zone: 2. Property Owner&Address: Daniel Berger Phone#: 914-565-0665 Cell#: email: danielmbergerl7@gmail.com 3. Contractor&Address: Innov8tive Environmental 392 Columbus Ave Valhalla, NY 10595 Phone#: 914-449-6608 Cell#: email: service@innov8enviro.com 4. Applicant: Innov8tive Environmental Phone#: 914449-6608 Cell#: email: service@innov8enviro.com 5. Indicate Fuel Type:Fuel Oil( )•L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: (1)275 Gal Aboveground Storage Tank 7. Exact Location(s)of each Tank: From the garage of the home t 2/21/2024 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. n Swom to efore me this Sworn to before me this 2 gL day of ,20 da of 12024 i bff== \X Signature of Property O e Signature of Applicant Daniel Berger Donnie Feeney nt Name oPPro rty Owner n Name of Applicant NORINE NORINE Al1EYER Notary Public,Sta" c Notary Public,State of New Yak Notary Public Llo.No.01 ME613 Lic,No.01 ME6130M Quallflsd in Westchester Coun`4r Qualified in Westchester Coun Commission Expires July 25,20LJ Commission Expires July 25,20 '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 2/21/2024 eo � NNOVt TIVE ENVIRONMENTAL SERVICES INC . July 15, 2024 Village of Rye Brook Building Department 938 King Street Rye Brook, NY 10573 V \,s_ ,_��VI[ I � RE: Daniel Berger 69 Rock Ridge Dr J U L 2 9 20-94 �--J Rye Brook MP-24-074/MP-24-075 VILLAGE OF RYE BROOK BUILDING DEPARTMENT To Whom It May Concern, This letter is regarding the work performed at 69 Rock Ridge Dr, Rye Brook in accordance with permits#MP 24-074 and#MP 24-075. Innov8tive Environmental Services (IES)was contracted by Daniel Berger to remove (1)275Gal Aboveground Storage Tank(AST)from the garage of the home and install (1)275 Gal AST in the same location as the removal. IES performed the work on June 21, 2024. IES pumped 38 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 Brookfield, Elmsford, NY.A scrap tank ticket is attached for your viewing. At this time, IES is requesting closure of permit#MP-24-074 and MP-24-075. Please advise if any additional information is required. Thank you, t - :�.�r-ram/ Donnie Feeney Innov8tive Environmental Services Innov8tive Environmental Services Inc. 392 Columbus Avenue, Valhalla NY 10595 service(Winnov8enviro.com 1 (914) 449-6608 www.innov8enviro.com NON-HAZARDOUS WASTE MANIFEST Please print or type (Form designed for use on elite If 2 pitch)typewriter) NON-HAZARDOUS 1.Generator's US EPA ID No Manifest 2 Page WASTE MANIFEST Document No. l of 1 3.Generator's Name and Mailing Address 4.Generator's Phone 5.Transporter 1 Company Name 6. US EPA ID Number A.Slate Transporter's ID Innov8tive Environmental Services N Y R 0 0 0 2 3 9 2 1 0 B.Transporter1Phone 914-449-6608 7,Transporter 2 Company Name 8. 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.State Facility's ID Clean Water of NY N Y 0 0 0 0 9 6 8 5 4 5 3249 Richmond Terrace F.Facility's Phone Staten Island, NY 718-981-4600 11.WASTE DESCRIPTION 12. Containers 13. 14. Total Unit No. Type Quantity WI.Nol a. Non RCRA, Non DOT liquid (Oily Water) 1 T T SIRGallon G b. E N E R A T O W R d H N QG.Additional Descriptions for Materials Listed Above H.Handling Codes for Wastes Listed Above Cn O 15.Special Handling Instructions and Additional Information ZApproval O 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 PrintedlTyped Name Sin Month Day Year Donald Feeney - As Agent for — — a Z T 17.Transporter 1 Acknowledgement of Receipt of Materials Date R A Printed7Typed Name Signature Month Day Year N s P 0 18.Transporter 2 Acknowledgement of Receipt of Materials --_ Date R Printed/Typed Name Signature Month Day Year E R 19.Discrepancy Indication Space F A C 1 20.Facility Owner or Operator.Certification of receipt of the waste materials covered by this manifest,except as noted in item 19. L 1 Date T Printed/Typed Name Signature Month Day Year Y 11111111111111 PAYMENT RECEIPT Brookfield Resource Management 100 Lamont Street Elmsford, NY 10523 914-592-5250 Receipt:1875677 Date:6/22/2024 Customer:69802 Time:2 23,50 PM INNOVATIVE ENVIRONMENTAL 392 COLUMBUS AVE VALHALLA, NY 10595 ID Number Ticket:1934064 Weigh In:6/22/2024 2:17:25 Operator:Romy C Weigh Out:6/22/2024 2 23 48 PM Commodity Gross Tare Net Price TOTAL$ Tanks 16,980 16,200 780 2.2300/CW 17.39 ------------------------------------------------------------------------ Ticket Total: 17.39 No.of Tickets:1 EZCash Paid: $17.00 Payment Method:EZCash Round Amt: ($0.39) Total Paid: $17.0 For current pricing,hours and contact information check us out on the web @brookfieldscrap.com Join Brookfield Scrap on Facebook Qwebuyscrap �, f,.., �4, _ .+r r r r{ � � � } .. _� - ! ' y � � �4 1 � �ki\ 1 •{ � _ �, 1pi]{Ll` l 1 s \v �:i�h. � • � l '� 1 ,:� •. .r �� , � r,� 1 -'.' �' J, ' f i d �, -� � - �; s w M. r ,F • � tiny a l i i}4 J 4 �-f �+ 6 f: q 1 _ d Y Y 0 U � O CO T N L O l 4 L 00 cm ito 0 � ) > l f � U O1 v � NNQ u LO L.L v c L ? I I co I i I r J i tr v I � t a i N m C 1!i ' G1 � c O > m .�= Q N t \ O C j rl W � } � cD > lJ a J ONE — C Ql ra _ .. _ C M > Standard n Standard oil tank with strong welded lap joints SAFETY _ Bottom outlet configuration allows for natural elimination of water build Lip from condensation DURABILITY Electrostatic powder-coated paint Made of robust material PEACE OF MIND 10 years against manufacturing defects('See warranty certHicate for details.) Contractor-friendty,trouble-free installation Product Camil Model th2caluterss Dimensions Weight(lb.) 209101 120 Vertical 12 47'/23'130" 170 208101 138 Vertical 12 44'/27"/30" 160 208601 138 Horizontal 12 27"/44'/30" 160 207101 2.20 Stubbier/Vertical 12 44'/27"/48" 220 203201 G 230 Thin/Vertical grey 12 ""/22"160" 235 203701 G 230 Thin/Horizontal grey 12 22"!44'/60" 235 202201 240 Narrow/Vertical i 11 47'/23"/60" 265 202701 240 Narrow/Honizontal 12 23'/47"/60" 265 f 204701 275 Horizontal 12 27"/44"/60" 255 211201 275 Vertical 10 44'/27"/60" 330 211701 275 Horizontal 10 27'/44"/60" 330 205201 330 Vertical 12 44'/27"/72' 290 205701 330 Horizontal 12 27"/44'/72" 290 t�sA YHhr.. ..',�.�A jY usA� .•tN�A��. �� fib.. Y a • �,' 'i v E � � „ }„ i'i't s. " � F?. �+ �!J �► FOP .,i �� �1�GO, 1 1/11 - f`ZII7: r1�1�111,1 1 Ij, «O)Y vi, N�11 • I`N1 ^ / O O iC LO 73 c w C �••+ Z ej w L t L V ❑ Con LO W �� 0) C - �' w � w o U � � .�, � to'kection We 0 co lss) 03 771 Of r c E «O)> cj rA jlblj4 re s d111 J AC-�'6 DATE(MM/DD/YYYY) Atilt" 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 EVlta Grande NAME: Mt Pleasant Capacity PHONE FAX P.O. Box 1689 •914-205-7682 ac No):914-205-7682 Pearl River NY 10965 ADDRESS: Evita.Grande@mtpcap.com INSURERS 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 1 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1933147098 REVISION NUMBER: rHIS 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMIDDIIYYYY MM LICY EFF POLICY EXP LTR /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CCP1193364 2/14/2024 2/14/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE FTI OCCUR PREMISES Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL BADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY PET LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ B AUTOMOBILE LIABILITY 01666398 1/15/2024 1/15/2025 COMBINED SINGLE LIMIT $1,000,000 Ea accident IxANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accdent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? N/A (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/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 Euoat. ©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 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^^ ^^^^ 824703808 MT PLEASANT CAPACITY AGENCY 1 BLUE HILL PLAZA STE 1689 PEARL RIVER NY 10965 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER I 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:/M/WW.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 STATE SUR NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER. 522201643 U-26.3