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HomeMy WebLinkAboutMP24-147 �yE BR A Lt V.r 19 L`��VVy 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 November 26,2024 Glen Schuster&Julie Schuster 2 Bobbie Lane Rye Brook,New York 10573 Re: 2 Bobbie Lane, Rye Brook,New York 10573 Parcel ID#: 135.35-1-31 This document certifies that the work done under Mechanical Permit#24-147 issued on 11/8/2024 for the installation of a new above-ground oil tank has been satisfactorily completed. Sincerely, Steven E.Fews Building&Fire Inspector /to �E aRnV� o`` tim Q 1982 BUILDING DEPARTMENT ❑$UILDING 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 : DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: 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 �G ❑ L.P. GAS II j FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL V�Qh ( � ❑ OTHER � w Ww Lin -0 N N W Cr x N „ u CA A W � Icn CA F a 2 x w 0 4 _ a;7 . .'•a " i fi a �+ � v A o � °ed 3 w q14 , v v W en W Ak O a f'O ' o .: O a : w w � � � w x r. � cv x00 C/3 W I� Cj Z;' b ° '" v, 0 EU ocV] W w -d u w C ICI U Z 0.0 cc o � �4 }� 00 G� � a H pip d4 Adb a OZ`7- U DC U Uo v � v � x 00 CV � .. A a Z BUILDING DEPARTMENT VILLAGE OF RYE BROOK D 938 KING STREET RYE BROOK,NY 10573 NOV - 7 20A (914)939-0668 %vwK.rvebro9k org VILLAGE OF RYE BROOK BUILDING DEPARTMENT Application for Permit to Install Fuel Storaie Tank (`Storage Tanks in excess of 1,100 gallons require registration with the County of Westchester) FOR OFFICE USE ONLY: PERMIT#: 'I! 7 Approval Date: �T Permit Fee: S Approval Signature: Other: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BV 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 S750.00 REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: I.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 81 1): 6. Inspection by Building Department for installation. 7. Submit all Manifests& Reports(if applicable, 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 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(Buried in Ground ( ) 1. Address:,2 8fmv SBL: / 3�� Zone: 2. Property Owner& A77ddress ✓b ob Phone 4: liy (1 Lq )q] Cell #: / email�[p.S(_ l �{�I�Q ►/f1— C(),� 1 3. Contractor&Address-:a D V t h Lie cn�rry n 7C(� __��r eI t CQ SOki �r� Phone#:75 Cell#: email: SPrUI(.Q Cw/)?/?�V3 /�✓t/�Or�(�/ 4. Applicant: ���, J T >°1LUA& Phone 4:71q yU q WC)'? Cell#: email: 5. Indicate Fuel Type: Fuel Oil(V-"L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: als 7. Exact Location(s)of each Tank: A i 10/30/2023 S ATE OF TEE 'YORK.COUN7Y OF WESTCHESTER I as. being duly sworn.deposes and states that he/she is the applicant above named, (prim ante Ail'tndn ainal signi ;an the applicant) and further states that Mile is the legal owner of the property to which this application pertains,or that(s►he is the COA /q C IW for the legal owner and is duly authorized to make and file this application.tindicale aRhitecl.cunUac Wr.agent_arUxnev ell') That all statements contained herein are true to the best of his,'rer 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 thisr)y day of ov day of �] .20 Si [lure of Prope Ow ignature of Applicant F ' t Name of Properly Owner Print Name of A plieant YEFt tyORINE1M-u11Vew York otary Public Note"y PubIiCOSME�j30633 O�ry Public LAC.No sler County ��l`l,yyaifA 1 au,ali f Westche 2()� Comm' ion SxPires July 25, 1-his application must be properly completed in its entirety and must include the nota 'ft signature(s)of the legal owner(s)of the subject property,and the applicant of record i � aces 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. x 10/30/2023 Oz _ coui V co f am: O }Q L�J i ~ W` O Z l J �c CD Q. mLD O JJi C m >m I N O I "W i J c o, 00> o p i V I h N aj v a y v E c i c W Ln Q Ln o O� w � r E Z co O > U co O N s V I i f Roth's state-of-the art double-wall tanks are the best you can find, More for the environment More for your safety More quality More than 4 million installed -NEW 30-YEAR PRODUCT WARRANTY- Follow the links below for more information, Overview Characteristics Specifications Dimensions for individual tanks Tank Model DWT DWT DWT DWT DWT 400L 620L 1000L 1000LH 1500L Nom.Capacity USgal 110(400, 165(620 275(1000) 275(1000 400(1500, (Illers, Length inches(cm) 29(74) 29(74) 43(110) 51(130) 6.4(163) Width inches(cm, 28(72) 28(72, 28(72) 30(76) 30(77) Height inches(cm) 44(112) 61(155) 61(155) 54(137) 68(173) Min.Height Req'd inches 49(125 i 66(16& 66(168) 60(152) 76(193) (cm; Tank Weight lbs.(kg) 106(48) 132(60) 167(76) 208(94) 333(151) Shipping',Veght lbs.(kg 115(52 143(65� 185(84) 23((104) 358(162) Dimensions for grouped tanks Tank Model DWT 400L DV T 620L DWT 1000L DWT 1000LH DWT 1500L 2Tanks 29x60 29x60 43x60 51x63 64x63 (side by side (74x 152) (74x 152; (110x234, (130x160, (163x 160 3 Tanks 29x92 29x92 43x92 51 x96 64x96 (side by side) (74 X 234)(74 X 234) (110x234) (130x244) (163x244) 4Tanks 29x 124 29x 124 43x 124 51X129 NIA (side by side (74x315) (74x315) (110 X 315 (130X 329; STanks 29056 29056 43x 156 51X162 (side by side (74 X 397) (74 X 397) (110 X 397) (130x411) NIA 2Tanks NIA NIA 28x90 NIA NIA ena to en 72 X 229 �k. k. ~ / ai AL 1� n i L j ' .1 V U y 1 O L w 'O.• I. i r••i W I: L .r W u z ,..r_ W Z) LO LO Ion (1) oE ad 00 --� Z - ice. prt , .� >_ xLIJ CN z 00 it � Y come ` y Qr Z El O _ <� :`.: `°`Y.i:'�- .J--::::-" -,r_ :-^c+; -w •m ��-.>-' a .;..- - :.�,. �' . 9 DATE(MMIDD/YYYY) AC")?" 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 PHONENo,Exti.914-205-7682 ac No:914-205-7682 P.O. Box 1689 E-MAIL Pearl River NY 10965 ADDRESS: Evita.Grande mt Da .com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Century Surety Company 36951 INSURED INNOENVI INSURERB: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 TYPE OF INSURANCE INgn SUBR POLICY NUMBER MMIDDIYYYY MM/DD_P� POLICY/YYYY LTREXPT LIMITS A X COMMERCIAL GENERAL LIABILITY CCP1193364 214/2024 2/14/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO R CLAIMS-MADE lxj OCCUR PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 M'OTHER L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $3,000,000 : $ B 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 LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY Y/N STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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 // �&&__ r ©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 (RENEWED) ^^^A^^ 824703808 MT PLEASANT CAPACITY AGENCY 1 BLUE HILL PLAZA STE 1689 he:E 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 51245 10/02/2024 TO 10/02/2025 10/2/2024 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:/NNWW.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 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 AMOUNTS WE PAID IN 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 STATE SUR NCE FUND F �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 676702696 U-26.3