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HomeMy WebLinkAboutMP15-178 �QyE DRY O br4 L 190 VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914) 939-0668 Christopher J.Bradbury www.ry-e b ro o kny.go v TRUSTEES BUILDING& FIRE INSPECTOR Susan R.Epstein Steven E. Fews Stephanie J. Fischer David M.Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE February 20,2025 Brian Butler&Bonnie Buder 39 Rock Ridge Drive Rye Brook,New York 10573 Re: 39 Rock Ridge Drive,Rye Brook,New York 10573 Parcel ID#: 135.35-1-25 This document certifies that the work done under Mechanical Permit#15-178 issued on 10/21/2015 for the removal of an above-ground oil tank has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to QyE BR(b, cu � t7�i� 1982 BUILDING DEPARTMENT ❑BULLDING 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 : ! /7> , -'^ l Z ( DATE: 01) PERMIT# ISSUED:' - SECT: BLOCK: LOT: Z 5' 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 r ❑ NATURAL GAS LJ L_r P Q ❑ L.P. GAS ❑ FUEL TANK L ❑ FIRE SPRINKLER L A-S-e m e �.J , ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL 2 ❑ OTHER P -j n 1 --OHVEC Hudson Valley Environmental & Construction NF 462 Lakeview Ave.Valhalla,NY 10595 1-877-811-HVEC November 24,2015 R [E C t-E O V L_ DEC — 1 2015 Village of Rye Brook VILLAGE OF RYE BROOK Building Department BUILDING DE PART IENT 938 King Street Rye Brook,NY 10573 Re: 39 Rock Ridge Drive Rye Brook,NY 10573 Dear Inspector, On November 17,2015 Hudson Valley Environmental&Construction performed the removal of a 275-gallon aboveground oil tank at 39 Rock Ridge Road Rye Brook,NY 10573 . Enclosed find all pertinent information for closure of permit. Thank you and please do not hesitate to contact me if you need any further information. Sincere , .00 Damien Coleman Hudson Valley Environmental&Construction I :NVIRO WASTE OIL RECOVERY, LLC Enviro Waste Sales Order Number3j0392 I 179 Route 6• P.O.Box 747 O'a e". 5t' gi-4�7 Sales Order Date: iffl S PAahopac, NY 10541 1-866-WASTE-OIL Page: :1h: (845) 279-0263 !��I�1114��tl�l�Il�il 1 li�l =ax: (845) 621-3075 �� ii� Ilil�l ! H t� SHIP TO: SOLD TO: HUDSON VALLEY ENVIRQ-Ja�TE NUDSaN VALLEY ENVIRONMENTAL �y ROCK RIDE DRIVE 4fi2 LAKEVIEYIf AVE RYE BROOK,NY 10a73 VALHALLA,NY 905y� SAL REP NA PO NUMBER USTOM RID {-i�ji.��E �1-5`7-j56 SHIP PAYMENT TERMS i PING METHOD p CUSTOMER CONTACT CREDIT CAF EI 917-440-9665 (I STATE ID NO DESIGNATED FACILITY 5 f USA EPA ID NO P•IYD044g25636 ADDRESS 279 RT S t+,j..�L-Irjpb,(� NY 10541 TOTAL I DESCRIPTION UNIT COST QUANTITY ITEM 700 OILY-WATER DISPOSAL � 721 USEDQILDISPOSAL-OFF/SPEC —3—$ 742 SLUDGE DISPQS,AjfT.Aj%K BOTT _--5--- 7.46 VAC SERVICE ---�--- 748 VAC TRUCK HOURLY RATE ` VA.0 OUT TUES 11f17@. 11AM CAL& :SLUDGE Subtotal 914-347-19?2 Sales Tax(7.3:° ) Total A/F WNV FILTERS W/O------- W faF_ — HERWISE INDICATED IN THE PAYMENT SECTION.INVOICES REFLECTING Cry ARE SUBJECT TO AN INTEREST RATE OF THE CHARGE MY ACCOUNT FOR THIS TRANSACTION UNLESS OT WASTE OR 1-'B�PER TO RECOVER COSTS OF THE LECTIONINCLUDING RE SONABLE AATTORNEY SOFEESS THAT NOT PAID 30 DAYS IN-THE EVENT OF DEFAULT,ENVIRO LESSER .•. Lot. •. • • • • CONTAINERS TOTAL UNIT NYD044825636 NO TYPE pUANTITY WTNOL US DOT DESCRIPTION j (i.�C,�• U� D.O.T. HAZARDOUS MATERIAL) USED OIL, ION REGULATED, �.� PETROLEUM ONTAMIh+kTcJ'?`fATER, NON u.D.T., NON R.C.R.�. 1 � { f ATOR AGREES TO INDEMNIFY AND HOLD ENVIRO WASTE HARMLESS FOR CATEGORIES: TH MATERIALS CONTAINING POLYCHLORINATED BIROWALS(PCB)OR ANY OTHER MATERIAL DEFINED AS HAZARDOUS WASTE ARE WITHIN ONE OF TrfE FOLLOWING GENERATOR WARRANTS AND REPRESENTS THAT THE MATERIALS PROVIDED ENVINE WASTE HEREUNDER HAVE NOT BEEN MIXED.COMBINED,OR OTHERWISE I CERTIFY THAT MY TOTAL WAaSTE STREAMS BLENDED IN ANY pUANTITY W UNDER APPLICABLE LAWS.INCLUDING BUT NOT LIMITED TO 40 CFR PART 26T.GE Q T IO�p NTH ANY pAMAGES.COSTS,ATTORNEY'$FEES,ETC.ARISING OUT OF OR IN ANY WAY RELATED TO A BREACH OF THE ABOVE WARRANTY BY THE GENERATOR ENVIRO WASTE.ITS AGENTS AND CpNTRACTORS HAVE THE CAPACITY AND ARE E OF THED AND PERMITTED IN ACCORDANCE E WASTE LISTED ON THIS DOCUMENT WITH ALL APPLICABLE LAWS S 1 ttlIT1AL ' AND REGULATIONS.TO TRANSPORT.ACCEPT.STORE,RECLAIM OR ANDIOR DIS GENERATOR CERTIFIES THAT THE WASTE IS+�j.l,JSED OIL ]USED ANTI-FREEZE ]OILY WATER 00THER ' 220 LBS TO 2.2W LBSIMONTH INITIALS DEXSIL CDT D TnE TEST RESULTS GREATER THAN 2.2W LBSIMONTH «PINT INITIALS PPM ���'�---- �""�--�'i��—� GENERATOHiCUSTOMER . . ~ ����U�����lF ��d���U��l� PAYMENT" """~-.� " RECEIPT Brookfield Resource Management 1DD Lamont Street Elmsford. NY1O523 914'592'5250 Rece|pt: 1O5O707 Date: 11/19/2015 Customer: 33861 Time: 13:00 HUD80N VALLEY ENVIRONMENTAL *oz LAKE VIEW AVE VALHALL. NY 10585 Ticket: 1180426 VVeigh|n: 11/19Q015 15-00 Operator: 0 Weigh Out: 11/19/2015 13:09 Description: TRK#77 Commodity Tuoo Not Price TOTAL$ /oms 20840 18180 2060 U3U5/Cw/ $8.11 � � � Ticket Total $8.11 #nfTickets: 1 Paid byEZCaox Let Us Know How We're Doing (info@bnmohfia)doo.00mn) Ofts K N ;. i W 04 o V s •2: o : A �16 fco cC cc H fix, d • L, 3 0 Qj �tcction - qt0 . H V c O w w >, ✓o Ql z• L� OCN = f o 14\ � o Q •N 0 µne rA 4uroi ~ _. O . : 00 N /t0 V .. . . . . . . . . . . . . . . . . lk AC" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD 10/20/2015 015 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 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 Maria Plasencia NAME: Strategic Insurance Partners PHONE (973�667-2600 FA(AICX, No:(973)667-5842 492 Franklin Avenue ADDRE S:mplasencia@siprisk.com INSURER(S)AFFORDING COVERAGE NAIC# Nutley NJ 07110 INSURERA:Great Divide Insurance Co. 25224 INSURED INSURER B Harle svllle Insurance CO 23582 Hudson Valley Environmental & Construction INSURERC: 462 Lakeview Avenue INSURER D: INSURER E: Valhalla NY 10595 INSURER F: COVERAGES CERTIFICATE NUMBER-Certs for 2015-2016 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 ADDL UBR POLICY EFF POLICY EXP LTR IWVn POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100,000 A CLAIMS-MADE FxIOCCUR ECP200195214 /1/2015 /1/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC Professional/Pollution Limit $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BA 00000052518V /20/2015 /20/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Law Enforcement Fee $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRI ETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ _ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Coverages are subject to terms, conditions and exclusions on the above policies. 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 Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE Mark Grossbard/SAN __---� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 ignino5 nl Th. Ar:r)Pr)name-I I-am -I-of Ar:rIPr) a New York State Insurance Fund Workers'Compensation&Disability Benefits Specialists Since 1914 105 CORPORATE PARK DRIVE SUITE 200,WHITE PLAINS,NEW YORK 10604-3814 Phone:(914)253-4861 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE AAA AAA 271014843 HUDSON VALLEY ENVIRONMENTAL&CONSTRUCTION CORP 462 LAKEVIEW AVENUE VALHALLA NY 10595 POLICYHOLDER CERTIFICATE HOLDER HUDSON VALLEY VILLAGE OF RYE BROOK ENVIRONMENTAL&CONSTRUCTION CORP 938 KING STREET 462 LAKEVIEW AVENUE RYE BROOK NY 10573 VALHALLA NY 10595 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE W2097 383-0 62325 04/05/2015 TO 04/05/2016 10/20/2015 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO.2097 383-0 UNTIL 04/05/2016, 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 SAID POLICY IS CANCELLED,OR CHANGED PRIOR TO 04/05/2016 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS POLICY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION. JAIME COLEMAN-PRESIDENT DAMIEN COLEMAN-VICE PRESIDENT OF HUDSON VALLEY ENVIRONMENTAL& CONSTRUCTION CORP 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 INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif.com/cert/certval.asp or by calling(888)875-5790 VALIDATION NUMBER: 546746868 U-26.3