Loading...
HomeMy WebLinkAboutMP25-063 DR J �' c 7. 19 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 David M. Heiser Donald T. Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE June 30,2025 Irene Mendicino 29 1/2 Highview Avenue Rye Brook,New York 10573 Re: 29 '/z Highview Avenue, Rye Brook,New York 10573 Parcel ID#: 141.35-2-17 As per the Certification letter from Enviroshield Inc. dated June 26, 2025, the removal of an underground oil tank under Mechanical Permit#25-063 issued on 5/13/2025 has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to �E BRO T 1932 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 : l 1� �y y . e-t j A E DATE: b` p( 7 C.2 0dlr PERMIT# m P Z ISSUED: -13'Z%SECT:/'/,3S BLOCK: Z LOT: 1 LOCATION: r />_ 'A A(- ,� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... U✓ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS `S' Af- r •� � VLn'n ❑ L.P. GAS J�r-PUEL TANK � � ✓Q. ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION •I FINAL 2- 7 _ dy ocS ❑ OTHER / AL L W J/L)C CO rn D (A-]c� �• � • jo �E 4RCuk O�` tim w � 1932 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 :_ 2 ! /Z k I C-ii Y t Pw E • DATE: (" 19 - Z oar PERMIT# rm P 2S - O(p 3 ISSUED:,5-/ SECT: •3.S BLOCK:_LOT: 17 LOCATION: Fapl-A v�"'1 WK► 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 d ✓ 2O u�J ❑ L.P. GAS .ET'FUEL TANK 20 ❑ FIRE SPRINKLER // P Q! ,411 ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER - 1 N f o Q. F.iyy i a o Sim 10- 1 ,, Corn r .. 4' ,SR . e �'�' ;'=fir , ,� � •- ti � AA r r�': y• ' 7 ♦tie L�.�t .) TWA 7n,YYyyy���'' '=I f'' ♦ ,� J ,,� l •�' +v' Q '~y -.%r5� ,.1' .T� dam' f J - cjNL r1' •� �r.y h ) tj.i •�'n 1. � 1 + � -�- { � / ��• fit•. I -�.�ry.. +h •�.' �^+iY a r'�y�.�jtpt `� � �~!t�.-"'mot � ,- �� .a r• � .. Ewa► yl 'aft. 7 Y �+ � c.'t. a'k• Jr .,,� �r � -t /fui� h' a.. �r +� 1M' .r .�. a�. C,. 1 � .. � •. . . Ate. i •'low `�r .:l s �3 a e M W O ►n � ar 'b cV � N ■ In Ln pCA W m c� ■ � }� � ►- Phi Cn 1�� �1 t w �r Q ■ LA W a v v 3 w bq �W�yy en C Cp Q �' W oip 72y Q Q -d P.-d a v' ■ z b 04 L n z F; n Oc O Wo ° avy° o U 00 F " o � � 'D p. ' Q � � a cn m Jw z O °a ■ �y F+i w U 0 � v M w o z Lei Gy z H w o A o � •� �� z a W. .9 ob s U" BUILDING DiA,,RTMENT ^� VILLAGE OF RYE OOK MAY — 2 2025 938 KING STREET RYE BR o NY 10573 (914 -0 Uri' VILLAGE OF RYE BROOK BUILDI\'G DEPARTMENT' I%I . oV -- 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#: jg, ,, �/ t Approval Date: MAY Z _•ermit Fee: S ��" Approval Signature: Other: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED Bl•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 REOUIREMEN'rS 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: emoval r Abandonment S 185.00 per Tank. 5.Dig Safely New Yor (dial 811): c`+3 eS - c o% - �-- 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, JPR+'Z`,- 3a.�ZS 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( )• Buried in Ground(y' 1. Address: y12 �+� ' ' — SBL: ,3j c �� Tone:�' 2. Property Owner&Address: (�R � n' '0`�-►r�+c , -�� "�,�^,'�^ �� �y�- f"=� Phone#: �cs3"b ��o t Cell#: C:A email: _ 3. Contractor& Address: C;S\.1%. �L6t� Phone#: ` 3 '3�ti 'sb`�`� Cell#: 4. Applicant: ��+2c 5�,. -,c {�f fr.+a� S-�2 :;7 r ra i- u- Aik,i. Phone#: `�3 � 5)WA`V Cell#: email: ' 5. Indicate Fuel Type:Fuel Oil(If-L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: �' � �9 b,; 7. Exact Location(s)of each Tank: t 6/1/2024 :STATE OF NEW YORK,CjOUNTY OF WESTCHESTER ) as: �r_-/e �i!AO/,4,//IQ 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 Tank Installation Contractor for the legal owner and is duly authorized to make and file this appltcanon. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use .�-knaucted 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 bcfoke me this Sworn to before me this (Ja day of 20 day of QJA 20_ Signature of Property Owner Signature of Applicant ` /J rr V .t�. _L_r"c.__ 2M C//c.(rl r0 Print Name of Property O HOPE B. VESIA Print Name of Applicant Notary Public, State of New York No. 01 VE5084028 otary ublic Qualified in Westchester Count Notary Publi Commission Expires August 25,20[ DANIELLY NOVOLI-SANTOS Notary'Public,State of Connecticut his application trust be properly completed in its entirety and must inch M Cotn fission Expires May 27,2026 signature(s) of the legal owner(s) of the subject property, and the applicant of record in the space,- 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. a....____._,___ _.�_._ f . 6 l �� °I r� � � �� �� a4--.._ _��_- -_ -�--- -T� 4� � � �� 1 �� � 3� C""?i��b� -z-�� bZ i 3�ho�rz� c�i��p�,vJ s Clean, Preserve...Protect �OG ��► Environmental Specialists S� June 26, 2025 Mr. Dominic Falcone Service Manager Westmore Fuel Company Inc. 86 North Water Street D FJUN O��/n Greenwich,CT 06830 E DD Subject: Tank Removal,June 18,2025id 7 2025 Mendicino Resence 29-1/2 Highview Avenue VILLAGE OF RYE BROOK Rye Brook, New York BUILDING DEPARTMENT Dear Mr. Falcone: On June 18, 2025, Enviroshield completed the removal of one underground 550-gallon fuel oil tank located at the subject property. The former location of the tank and progression of the tank removal process is shown in Site Photographs enclosed with this letter. Prior to the removal of the tank, all remaining liquid, sludge sediment and rinse water were pumped and cleaned from the tank for disposal by Enviroshield, Inc., a State of New York licensed waste transporter at Tradebe Treatment and Recycling of Bridgeport LLC, 50 Cross Street, Bridgeport, Connecticut. Attached is a copy of the waste transport bill of lading. The top of the tank was exposed using an excavator and enough soil was removed from the excavation to pull the tank from the ground. The tank was thoroughly inspected for rust, cracks, holes, or other physical characteristics,which could have been cause for a fuel release. No evidence of a fuel release was observed. Soil samples obtained from the tank grave were screened using the Photo Ionization Detector (PID); the results of the field screening indicated no evidence of a fuel release. A soil sample was collected from the bottom of the excavation, in the area presumed to be most impacted, and submitted to a Complete Environmental Testing (CE l), a State of New York certified environmental laboratory for analysis by SPARS 8260 and 8270. Consistent with New York State — Department of Environmental Conservation (NYS-DEC) requirements, these are the required analyses for oil tank removal in New York State. As indicated in the attached Complete Environmental Testing (CET) report #25170568 (and the attached Table 1 — NYSDEC CP-51 Regulatory Comparison to Soil Sample Result) the reported results for the sample tested were all below the current NYS-DEC Guidance Values for the constituents tested. CT Home Improvement Contractor HIC.0582591 —Westchester Home Improvement License WC-27310-H 14 250 Moffitt Street, Stratford, CT 06615 (203) 380-5644 FAX(203)378-8736 www.enviroshield.com- info@enviroshield.com Page 2 of 2 June 26, 2025 Mendicino Residence 29-1/2 Highview Avenue Rye Brook,New York The tank was transported, cleaned, and disposed of at P.C. Metals, Inc., 270 Central Avenue, Bridgeport, Connecticut in a manner consistent with industry standards and in compliance with all Local, State and Federal Codes and Regulations.Attached is"Tank Disposal'Picket#599818. The tank grave was backfilled to grade. Based on visual observations, PID field screening and laboratory analysis, Enviroshield found no indication of the tank system's failure. If you have any questions concerning any of this work, please do not hesitate to contact me at your earliest convenience at (203) 380-5644. Sincerely, Enviroshield Inc. Lecma4d Leonard Bochicchio s6 Senior Project Manager Enclosures cc: Village of Ryc Brook Building Department via email f1C)L a?rvebr c-x knl',�m, and 1'cterscn�tli�reb,�ukm'.�;�w Permit#MP 25-063 [ECF. �YE JUN 2 7 2025 DD VILLAGE OF RYE BROOK BUILDING DEPARTMENT Site Photographs Enviroshield 550-galton Underground Storage Tank(UST) Removal Mendicino Residence, Brook, • may., �• .. Photo 1 of 4. Location of UST; white flagged. h _ { • . . visible fit(pipe. Site Photographs Enviroshield 550-gallon Underground Storage Tank(UST) Removal Mendicino Residence, 29-1/2 Highview Avenue, Rye Brook, New York u .S t Photo 3 of 4. UST lifted from the ground. Photo 4 of 4. Former location of UST. Clean, Preserve...Protect �i►�'O` Specialists Environmental S P � 5 BILL OF LADING DESCRIPTION: Check applicable waste ID: ),�l(NA1993) Fuel oil/diesel/waste oil _ (UN1203) Gasoline _ (UN1223) Kerosene Off-Specification commercial chemical product fuel (applicable in CT only) _ Waste, NON-RCRA, Liquid, N.O.S. (Oil/Water mix) Non-Haz, None (applicable in NY State) Water only (no fuel waste). Date: 2 Total Quantity: v gallons Generator Name: Site Address: 0 1 ( , City: l� l r�-1�� State: /? i zip: 1 Telephone: _ - f L4 VV.O#: ,r Generator/Agent for Signature: Transporter: Enviroshield, Inc., 250 Moffitt Street, Stratford'-CT 06615 203-380-5644 Connecticut: CT-HW-495; New York: CT-0�95rWestchester County NY: WC-27310-H14; Connecticut H.I.C. 0582591 Driver Signature: Destination/Facility: Tradebe Treatment and Recycling of Bridgeport, 50 Cross Street, Bridgeport,CT 06610 Safety Kleen Systems, Inc., 120 Forbes Avenue, New Haven, CT 06512 Tradebe Treatment and Recycling Northeast, 136 Gracey Avenue, Meriden, CT 06451 Approval Code: (SEE BACK FOR HAZARD/SAFETY/RESPONSE DETAILS) F 1Tennplates\Misc\B01 of Lading Liquid docx CT Home Improvement Contractor HIC.0582591 Westchester Home Improvement License WC-27310-1-1 14 250 Moffitt Street, Stratford, CT 06615 (203) 380-5644 FAX (203) 378-8736 ww-w.envirosh lei d.coin - info(a)enviroshield.com 80 Lupes Drive Tel:(203)377-9984 Stratford,CT 06615 Fax:(203)377-9952 e-mail:cetl@cetlabs.com COMR11f INVIRONMINIAI lf5iINO,II1111 Client: Mr.Richard Louis Enviroshicld,Inc. P.O.Box 1296 Stratford,CT 06615 Analytical Report CET# 25FO568 Report Date:June 25,2025 Project:Westmore/Mendicino 29.5 l lighview Ave Rye Brook NY PO Number: 30708 Connecticut Laboratory Certificate:PH 0116 New York NELAP Accreditation: 11982 Massachusetts Laboratory Certificate:M-CT903 Pennsylvania Laboratory Certificate:68-02927 Rhode Island Laboratory Certificate: 199 Page 1 of 13 CET 4:25FO568 Project:Westmorc/Mendicino 29.5 Highview Ave Rye Brook NY SAMPLE SUMMARY The sample(s)were received at 14.2eC. This report contains analytical data associated with following samples only. Sample ID Laboratory ID Matrix Collection Date/Time Receipt Datc Tank Grave 25FO568-01 Soil 6118/2025 10:00 06/18/2025 Analyte: Percent Solids ISM 2540 GI Analyst:AEP Matrix: Soil Dat&Time Laboratory ID Client Sample ID Result RL Units Dilution Balch Prepared Analyzed 25F0568-01 Tank Gravc 82 1.0 9. 1 BF52321 06/23i2025 06/23/2025 14:35 Complete Environmental Testing,Inc. 30 Lupes Dri\c,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 2 of 13 CET b:25FO568 Project:Westmore/Mendicino 29.5 Highview Ave Rye Brook NY Client Sample ID Wank Grave Lab ID: 25FO568-01 Semivolatile Organics Analyst: MJH Method: EPA 8270E Matrix: Soil Rcsult RL Date/Time Analvte (uglkg dry) (ug/kg dry) Dilution Prep Method Batch Prepared Analyzed Now, Naphthalene 550 120 1 EPA 3546 BF52439 06/24i2025 06/25/202510:55 Acenaphthylcnc ND 120 1 EPA 3546 BF52439 06124/2025 06/25/2025 10:55 Acenaphthene 250 120 1 EPA3546 BF52439 06/24/2025 06+'25/202510:55 Fluorene 200 120 1 EPA3546 BF52439 06/24/2025 06/25/2025 10:55 Phenantbrene 1800 120 1 EPA 3546 BF52439 06/24/2025 06/2512025 10:55 Anthracene 380 120 1 EPA3546 BF52439 06/24!2025 06i25/202510:55 Fluoranthene 1500 120 1 EPA 3546 BF52439 06/242025 06l25/2025 10:55 Pyrene 1100 120 1 EPA 3546 BF52439 06/24/2025 06/25/2025 10:55 Benzolelanthracene 560 120 1 EPA3546 BF52439 06/24,2025 0625/202510:55 Chrysene 600 120 1 EPA3546 BF52439 06/.412025 06:25/2025 10:55 Benzo[b111uor2nthene 560 120 1 EPA3546 BF52439 06/2420-15 06125.202510:55 Benzolklnuoranthene 220 120 1 EPA 3546 BF52439 06/242025 06!25t2025 10:55 Benzolalpyrene 420 120 1 FP.A3546 BF52439 06/24/2025 06/25/202510:55 Indeno[1,2J-cdlpyrene 170 120 1 EPA3546 BF52439 06724/2035 067251202510:55 Dibcazla,hlanthracenc ND 120 1 EPA3546 BF52439 06/24�2025 0625/202510:55 Benzolg,h,ilperylene 200 120 1 EPA3546 BF52439 06/24/2025 06/251202510:55 Surtgate:Moobetkene-d5 42 7% 7/1-130 BF52439 06/24/2025 0612512025 10:55 Surrogate:2-Fluornhiphenyt 51.2 Rio 311-Hn BF52439 06/24/2025 W25/2025 10:55 Surrogate:Te+phenYW14 69.0:5 30-130 BF52439 06/24i2025 06251202510:55 Volatile Organics Analyst:SJP Method: EPA 8260D Matrix: Soil Result RL Datc/Timc Analyte (uglkg dry) (ug/kg dry) Dilution Prep Method Batch Prepared Analyzed votes hlcthyl-l-Butyl Ether(MTBE) ND 5.4 1.75 FPA 5035A-L BP52031 06/_'0/2025 06/20/3025 12:37 Benzene ND 5.4 1.75 EPA 5035A-L BF52031 O6/'_'0/2025 06/2a2025 1137 Toluene ND 54 1.75 EPA 5035A-I. 13FS2031 06/202025 06i20/2025 12:37 Fthylbcnzcnc ND 5.4 L75 EPA 5035A-L 111.-52031 0&20!2025 06/20/2025 12:37 m+p Xylenes ND 11 1.75 EPA 5035A-1 BF52031 06/202025 06.200O25 12:37 o-Xylene ND 5.4 1.75 EPA 5035A-L BF52031 06/20/2025 06'.012025 12:37 hopropylbcnzene ND 5.4 1.75 EPA 5035A-L BF52031 06.07-0/2025 06/20/2025 12:37 n-Propylbenzene ND 5.4 1.75 EPA 503SA-1. BF52031 06120/2025 0&2012025 12:37 1.3.5-Trimetliylbcnzcnc ND 5.4 1.75 EPA 5035A-1. BF52031 06!20/2025 06+202025 12:37 Complete Environmental Testing,Inc. 80 Lupes Drive,Stratford.CT 06615-Tel:203-377-9984-Fax:203-377-9952-www.cetlabs.com Page 3 of 13 CET M:25FO568 Project:Westmore/Mendicino 29.5 Highview•Ave Rye Brook NY Client Sample ID Tank Grave Lab ID: 25F0568-01 Volatile Organics Analyst: SJP Method: EPA 8260D Matrix: Soil Result RL Da;c.7i ne Analvte tuglkg dry) (ugrkg dry) Dilution Prcp Method Batch Prepared Analyzed Notes ten-Butylbenzene ND 5.4 1.75 EPA 5035A-1. BF52031 (W20/2025 06/20/2025 12:37 1,2,4-Trimeth)lbenzene ND 5.4 1.75 EPA 5035A-L BF52031 W20/2025 06/20/2025 12:37 scc-Butylbenzene ND 5.4 1.75 EPA 5035A-L BF52031 0620/2025 06/20/2025 12:37 4-1sopropyltoluene ND 5.4 1.75 EPA 5035A-1. BF52031 06/20i2025 06/20/2025 12:37 n-Butvlbcnzenc ND 5.4 1.75 EPA 5035A-L BF52031 06/20!2025 06i20/2025 12:37 Naphthalene ND 11 1.75 EPA 5035A-L BF52031 06/20/2025 06/20/2025 12:37 Surrogate:1.2-Dic*luroethune-d4 113% 74-130 BF52031 06/20r2025 061201202512:37 Surrogate:Toluene-dR 97.0% 70-130 BF52031 06/20/2025 067201202512:37 Surrogate:4-Bmmu luorohen_eue 102% 70-130 BF52031 06/20/2025 06,7012025 12:37 Complete Environmental Testing,Inc. 80 Lupes Drive,Stratford,CT 06615-Tel:203-377-9984-Fax:203-377-9952-www.cetlabs.com Page 4 of 13 CET N:25FO568 Project:Westmore/Mendicino 29.5 Highview Ave Rye Brook NY QUALITY CONTROL SECTION Batch RF52031-EPA 8260D Result RL Spike Source no Rec RPD Analyte (uglkg) (ug-kg) Level Result %Rec Limits RPD Limit Notes Blank(BF52031-BLK 1) Prepared:6120/2025 Analyzed:6/20/2025 Methyl-t-Butyl Ether ND 2.5 Benzene ND 2.5 Toluene ND 2.5 Ethylbenzene ND 2.5 m+p Xylenes ND 5.0 o-Xy►ene ND 2.5 isopropylbcnzenc ND 2.5 n-Propylbenzene ND 2.5 1,3,5-Trimcthvlbenzene ND 2.5 tert-Butylbencene ND 2.5 1,2,4-Trimethylbenzene ND 2.5 sec-Butylbencene ND 2.5 4 isopropyltoluene ND 2.5 n-Butylbenzene ND 2.5 Naphthalene ND 5.0 Surrogate.1.2-Dichloroethane-J4 lot 70-130 Surrogate:Toluene-dg 109 70-130 Sat-regale:4-8roroo/laombenzenc 98.5 70-130 LCS(BF52031-BSI) Prepared:6/20/2025 Analyzed:6/20/2025 Methyl-t-Butyl Ether(MTBE) 48.8 2.5 50.000 97.6 70-130 Benzene 48.9 2.5 50.000 97.7 70-130 Toluene 50.5 2.5 50.000 101 70-130 Ethylbenzene 47.7 2.5 50.000 95.3 70-130 m+p Xylenes 94.8 5.0 100.000 94.8 70-130 o-Xylene 47.9 2.5 50.000 95.8 70-130 isopropylbcnzcnc 49.2 2.5 50,000 96.4 70-130 n-Propylbenzene 46.9 :.5 50.000 93.8 70-130 1,3,5-Trimethylbenzene 48.0 2.5 50.000 96.0 70-130 tent-Butylbenzene 49.4 2.5 50.000 98.7 70-130 1,2.4-Trimethylbenzene 48.2 2.5 50.000 96.4 70-130 scc-Butylbenzene 49.7 2.5 50.000 99.3 70-130 4-Isopropyltolucnc 49.9 2.5 50.000 99.8 70-130 n-Butylbenzene 47.7 2.5 50.000 95.3 70-130 Naphthalene 50.9 5.0 50.000 102 70-130 Surmgete:1.1-Dicklnmethane-14 loll 70-130 Surrogate.Toluene-dg 104 70-130 Surrogate.'4-8ronro/htaohenzenc 104 70-130 LCS Dup(BF52031-BSDI) Prepared:6/20/2025 Analyzed:6/20/2025 Methyl-r-Butyl Ether(67TBE) 56.5 2.5 50.000 113 70-130 14.7 20 Benzene 49.8 2.5 50.000 995 70-130 1.81 20 Toluene 51.3 2.5 50.000 103 70-130 1.53 20 Ethylbenzene 52.0 2.3 50.000 104 70-130 8.67 20 m-p Xylencs 102 5.0 100.000 102 70-130 7.10 20 o-Xvlcnc 52.1 2.5 50.000 104 70-130 8.44 20 )sopropylbenzene 52.3 2.5 50.000 103 70-130 8.08 20 n-Propylbenzene 51.6 2.5 50.000 103 70-130 9.52 20 Complete Environmental Testing.Inc. 30 Lupes Drit e.Stratford,CT 06615-Tel:203-377-9984-Fax:203-377-9952-www.cetlabs.com Page 5 0f 13� CET N:25FO568 Project:Westmorc/Mendicino 29.5 Highview Ave Ryc Brook NY Result RL Spike Source %Rec RPD Analvtc (ug/kg) (ug/kg) Level Result %Rec Limits RPD Limit Notes LCS Dup(BF52031-BSDI)-Continued Prepared:6/20/2025 Analyzed:6/20/2025 1,3,5-Trimethylbenzene 52.7 2.5 50.000 105 70-130 9.40 20 tert-Butylbenzene 52.8 2.5 50.000 106 70-130 6.68 20 1.2,4-Trimcthylbenzcnc 53.0 2.5 50.000 106 70-130 9.43 20 sec-Butylbenzene 54.5 2.5 50.000 109 70-130 9.31 20 4-lsopropyltoluene 53.4 2.5 50.000 107 70-130 6.74 20 n-Butylbenzene 52.6 2.5 50.000 105 70-130 9.87 20 Naphthalene 52.7 5.0 50.000 1.05 70-130 3.48 20 Sanngate:1.%Dichlomerhane-dd 101 70-l30 Surrogate:Tiduene-d,9 96.8 70-130 Surrogate:4-Bromoflnorobenzene 99.6 70-130 Complete Environmental Testing,Inc. 80 Lupes DriN c,Stratford,CT 06615•Tel:203-377-9984-Fax:203-377-9952-www.cetlabs.com Page 6 of 13 CET#:25FO568 Project:Westrnorc/Mcndicino 29.5 llighview Ave Rye Brook NY Batch BF52439-EPA 8270E Result RL Spike Source %Rec RPD Analyte (ug%kg) (ug/kg) Level Rcsult %Rec Limits RPD L;mit 'Now; Blank(BF52439-BLKI) Prepared:6/24/2025 Analyzed:6/25/2025 Naphthalene ND 100 Acenaphthylene ND 100 Acenaphthene ND 100 Fluorcne ND 100 Phenanthrene ND 100 Anthracene ND 100 Fluoranthcnc ND 100 Pyrene ND 100 Benzo[a]anthracene ND l00 Chrysene ND 100 Benzolb]fluoranthene ND 100 Beuzo(k]fluoranthenc ND 100 Benzo(alpyrene ND 100 lndeno[1.2,3-cd]pyrene ND 100 Dibenz[a,h]anthracene ND 100 Benzo[g,h,i]perylene ND 100 Sur,+,�atr•Nitr�hrn_ene-JS 66.6 30-!O Surrogate 2-Awrohrphem,l 781 .0-UP Surrogate-Terphenj4414 85 9 30-130 LCS(BF52439-BSI) Prepared:6l2412025 Analyzed:6/25/2025 Naphthalene 3200 l00 4.000.000 80.0 40-140 Acenaphthylene 3430 100 4,000.000 85.8 40-140 Acenaphthene 3550 100 4.000.000 8R.7 40-140 Fluorene 3780 100 4,000.000 94.5 40-140 Phenanthrene 3920 100 4,000.000 98.0 40-140 Anthracene 4000 100 4.000,000 99.9 40-140 Fluoranthene 4150 100 4,000.000 104 40-140 Pyrene 4110 100 4.000.000 103 40-140 Benzo[a]anthracene 3960 100 4,000.000 99.1 40-140 Chrysene 4090 100 4.000.000 102 40-140 Bcnzo[bjfluoranthcnc 3940 100 4,000.000 98.5 40-140 Benzo[klfluoranthcne 4170 100 4,000.000 104 40-140 Benzo[alpyrene 4030 100 4.000.000 101 40-140 lndeno(1,2,3-cd]pyrene 3870 100 4,000.000 96.8 40-140 Dibenz(a.h]anthracene 3890 100 4.000.000 97.3 40-140 Benzo[o,h.i]perylene 3680 100 4,000.000 91.9 40-140 Surrogate Nianthcnaene-d+ 71 1 30-130 Sur",gare 2-Fhuuvhiph,til l -8_' 30-130 .Surmgare To-phon-f-d14 84.8 30-130 LCS Dop(BF52439-BSDI) Prepared:6/24/2025 Analyzed:6/25!_'025 Naphthalene 2930 100 4,000.000 73 3 40-140 8.72 30 Acenaphthylene 3250 l00 4,000.000 81.3 40-140 5.39 30 Accuaphthenc 3350 100 4,000.000 83.8 40-WO 5.59 10 Fluorenc 3590 too 4.000.000 99.9 40-140 5.01 30 Phenanthrene 3880 100 4.000.000 96.9 40-140 1.12 30 Anthracene 3970 100 4,000.OMl 99.1 40-140 0.777 30 Fluoranthene 4090 100 4,000.000 102 40-140 1.41 30 Pyrene 4020 100 4.000.000 to] 40-140 2.05 30 Bcnzo(alanthracenc 3920 100 4,000,000 97.9 40-140 1.18 30 Complete Environmental Testing.Inc. 80 Lupes Drive,Stratford,CT 06615-Tel:203-377-9984-Fax:203-377-9952-www.cetlabs.com Page 7 Of 13 CET r#:25FO568 Project:Westmore/Mendicino 29.5 Highview Ave Rye Brook NY Result RL Spike Source %Rec RPD Analvte (ug%kg) (uglkg) Level Result %Rec Limits RPD Limit Nrotcs LCS Dup(BF52439-BSDI)-Continued Prepared:6/24/2025 Analyzed:6125/2025 Chrysene 4100 100 4,000.000 103 40-140 0.309 30 Benzo[bjfluoranthene 3960 IOil 4,000,000 96.4 40-140 2.17 30 Benzo[klfluoranthcnc 4060 100 4,000.000 102 40-140 2.64 30 Benzo[alpyrene 3890 100 4,000.000 97.1 40-140 MO 30 Indenotl.2,3-cdlpyrene 3790 !00 4,000.000 94.7 40-140 2.20 30 Dibenz[a,hlanthracene 3800 100 4,000.000 94.9 40-140 2.45 30 Benzofg.h,i]perylene 3680 100 4,000.000 92.0 40-140 0.104 30 .Sunogute:.Vkrohen_ene-d5 660 M-130 Sunagure:l-Fluorrrhiphemf 739 30-130 Surrogate:Terphen)4414 822 30-130 Complete Environmental Testing.Inc. 80 Lupes DriN e,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•wM-Xv.cetlabs.cotn Page 8 of 13 CET k:25F0568 Project:Westmore/Mendicino 29.5 1-1ighview Ave Rye Brook NY 80 Lupes Drive 1*i" Tel:(203)377-9984 Stratford,CT 06615 CI MP111I I NVIRONMI N1AI 115f I NO,I NG Fax:(203)377-9952 email:cetl@cetlabs.com Quality Control Definitions and Abbreviations Internal Standard(IS) An Analyte added to each sample or sample extract. An internal standard is used to monitor retention time,calculate relative response,and quantify analytes of interest. Surrogate Recovery The%recovery for nun-target organic compounds that are spiked into all samples. Used to determine method performance. Continuing Calibration An analytical standard analyzed with each set of samples to verify initial calibration of the system. Batch Samples that are analyzed together with the same method,sequence and lot of reagents within the same time period. ND Not detected at or above the specified reporting limit. RL RL is the limit of detection for an analyte after any adjustment made for dilution or percent moisture. Dilution Multiplier added to detection levels(MDL)and/or sample results due to interferences and/or high concentration of target compounds. Duplicate Result from the duplicate analysis of a sample. Result Amount of analyte found in a sample. Spike Level Amount of analyte added to a sample Matrix Spike Result Amount of analyte found including amount that was spiked. Matrix Spike Dup Amount of analyte found in duplicate spikes including amount that was spike. Matrix Spike%Recovery %Rccovcry of spiked amount in sample. Matrix Spike Dup%Recovery %Recovery of spiked duplicate amount in sample. RFD Relative percent difference between Matrix Spike and Matrix Spike Duplicate. Blank Method Blank that has been taken through all steps of the analysis. LCS%Recovery Laboratory Control Sample percent recovery. The amount of analyte recovered from a fortified sample. Recovery Limits A range within which specified measurements results must fall to be compliant. CC Calibration Verification Flags: H- Recovery is above the control limits L- Recovery is below the control limits B- Compound detected in the Blank P- RPD of dual column results exceeds 40% k- Sample result too high for accurate spike recovery. Connecticut Laboratory Certification PH0116 New York NELAP Accreditation 11982 Massachussets Laboratory Certification M-CT903 Rhode Island Certification 199 Pennsylvania NELAP Accreditation 68-02927 Complete Environmental Testing,Inc. 80 Lupes Drip e,Stratford,CT 06615-Tel:203-377-9984-Fax:203-377-9952-www.cetlabs.com Page 9 Of 13 CET#:25F0568 Project:WestmorelMcndicino 29.5 Highview Ave Rye Brook NY All questions related to this report should be directed to David Ditta,Timothy Fusco,or Jeffrey Smith at 203-377-9984. Sincerely, This technical report was reviewed by Timothy Fusco David Ditta Project Manager Laboratory Director This report shall not be reproduced except in full,without the written approval of the laboratory Report Comments: Sample Result Flags: E-The result is estimated,above the calibration range. H-The surrogate recovery is above the control limits. L-The surrogate recovery is below the control limits. B-The compound was detected in the laboratory blank. P-The Relative Percent Difference(RPD)of dual column analyses exceeds 409"a. D-The RPD between the sample and the sample duplicate is high. Sample Homogeneity may be a problem. +- The Surrogate was diluted out. 'C l-The Continuing Calibration did not meet method specifications and was biased low for this analyte. Increased uncertainty is associated with the reported value which is likely to be biased low. •C2-The Continuing Calibration did not meet method specifications and was biased high for this analyte. Increased uncertainty is associawd with the reported value which is likely to be biased high. "F1-The Laboratory Control Sample recovery is outside of control limits. Reported value for this analyte is likely to be biased on the low side. 'F2-The Laboratory Control Sample recovery is outside of control limits. Reported value for this analyte is likely to be biased on the high side. "I-Analyte exceeds method limits from second source standard in Initial Calibration Verification(ICV). No directional bias. All results met standard operating procedures unless indicated by a data qualifier next to a sample result,or a narration in the QC report. For Percent Solids,if any of the following prep methods(3050B,3540C,3545A,3550C,5035 and 9013A)were used for samples pertaining to this report,the percent solids procedure is within that prep method. Complete Environmental Testing is only responsible for the certified testing and is not directly responsible for the integrity of the sample before laboratory receipt. ND is None Detected at or above the specified reporting limit Reporting Limit(RL)is the limit of detection for an analyte after any adjustment made for dilution or percent moisture. All analyses were performed in house unless a Reference Laboratory is listed. Samples will be disposed of 30 days after the report date. Complete Environmental Testing,Inc. 80 Lupes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.com Page 10 of 13 CET a:25F0568 Project:Wcstmore/Mendicino 29.5 Highview Ave Rye Brook NY CERTIFICATIONS Certified Analyses included in this Report Anslyte Certifications EPA 8260D in Soil Methyl-t-Butyl Ether(MTBE) CT.NY.PA Benzene CT,NY,PA Toluene CT.NY.P.4 Ethylbenzene CT,NY,PA m+p Xylenes CT,NYPA o-Xylene CT,NY.PA isopropylbenzwe CT.NYPA n-Propylbcnzcnc CT.NY,PA 1,3,5-Trimethylbenzene CT,NYPA tert-Bulylbenzene CT.NYP.4 1,2,4-Trimethvlbenzenc C r,N y,PA sec-Butylbenzene CT,NY,PA 4-Isopropyltoluene CT.NY.PA n-Butylbenzene CT,NY:PA Naphthalene CT.NY.PA EP.4 8270E in Soil Naphthalene CT.NYTA Accnaphthylene CT.NYPA Acenaphlhcnc CT.NY,1'A Flumene CYNY.PA Phenanlhrene CT,NYPA Anlhraccnc CT.NY,PA Fluoranthene CT.NY.PA Pyrene CTNYPA Benzo[ajanlhracene CT,NY,PA Chrysene CT.NY.PA Benzo[blfluorantbeuc CT.NY.PA Benzo(klfluoramhene CT.NY,PA Bcnzof alpyrcne CT.NY.PA Indeno[1,2,3-cdlpyrene CT.NY.PA Dibenz(a,hlanthracene CT.NY.PA Benzo[g.h.ilperylene CT.NY',PA SM 2540 G in Soil Percent Solids CT Complete Environmental Tcsting,Inc. 80 Lupes Drive.Stratford,CT 06615•Tel:203-377-9954•Fax:203-377-9952•www.cetlabs.com Page 11 of 13 CET#:25FO568 Project:NVestmorelMendicino 29.5 Highview Ave Rye Brook NY Complete Environmental Testing operates under the followingcertifications and accreditations Code Description Number Expires CI' Connecticut Public Health PHOi 16 0950/2026 NY New York Certification(NELAC) 11982 04101/2026 PA PennsylvaniaDEP 6"2927 05/31122026 Complete Environmental Testing.Inc. 80 Lupes Drive,Stratford,CT 06615•Tel:203-377-9984•Fax:203-377-9952•www.cetlabs.cofn Page 12 of 13 k310N M '1NOO 30 0 lb'101 s 0 N M C ❑ CL O c O c S ❑ t m 9 a c°n ❑ 3 � w m C E ru. S v O a a 0 j U CU d101 :. I z a dldS € o LL_ W ❑Ja1119 qe"I O-NI3 p18Li Z A paAJOssld w a CL / b V SIGIOW gl d3301O 4 LL O m C O51eleWEt'Nod�iNoud � r � E �Biaw 9 vaod 0 O V, Hd1310 u = w SBplolgjeH = Q a0i (• N SMOlised ` o LL BGOd Z a H LL p O HVd/Sb'Nd OLZB A -!ueBJO alllelOA-IwOS OLZ9 I - Z O 09Z9 auexo14 b'G U m a Q SUOBOIBH 09Z9 uj c $ g o O U ¢ m T CL Solleway o9Z9 m �7 re C n -!-610 8II1810A 09Z8 z O o ¢ ` u C M. V ...pjvp�4s E .ABQ—u_L a o c a m a p i c� Av(3lxaN ( 10 c ~ •ALO BWBS I m x g •c Elm � g331 �j 19" L d a � o OC Q( W m r� m m d u II W >I >atE E o E uj E 4 ," 0 LO 0) 00 W W m U V W U U U U m m m cc cc Cc M(O� U l 11 10 C CD 00�® Z O >S co ❑ 3 = d LU Z > w LUO CD a mo 1 1 o a� a o vJ U) o 0 0 l0 p $ Z I u E J 3F A2 a 11�1�1� 06 E a Cj a C J I CL a co (\LO CL v w -- •� m LA mLA. `8 0 0 � w >a> a, m > m ppp � � a U a f � Z JI I L \ -- - --� J CL U) u ~ � Z Z Z C VI A C w Z — J J � m I I 7 O ¢ O 'o wco w w Q a • Table 1—NYSDEC CP-51 Regulatory Comparison to Soil Sample Result Client: Enviroshield,Inc. Project: Westmore/Mendicino 29.5 Highview Ave Rye Brook NY Matrix: Soil Collect Dates: 6/18/2025 Lab Number 25F0568-01 Sampled Name Tank Grave Sampled Date 6/18/2025 Parameter IASNumbei Value Qual EPA 8260D ug/kg dry) Methyl-t-Butyt Ether(MTBE) 1634-04-4 2000 20000 1000000 500000 <5.4 Benzene 71-43-2 20 200 200000 21000 <5.4 Toluene 108-88.3 20000 67000 1000000 500000 <5.4 Ethylbenzene 100-41-4 10100 10100 1000000 500000 <5.4 m+pXylenes XYLMP 19500 19500 1000000 500000 <11 o-Xylene 95-47-6 19500 19500 1000000 500000 <5.4 isopropylbenzene 98-82-8 500 5000 1000000 500000 <5.4 n-Propylbenzene 103-65-1 1000 10000 1000000 500000 <5.4 1,3,5-Trimethylbenzene 108-67-8 2800 28000 1000000 500000 <5.4 tert-Butytbenzene 98-06-6 7000 70000 1000000 500000 <5.4 1,2,4-Trimethylbenzene 95-63-6 2800 28000 1000000 500000 <5.4 sec-Butytbenzene 135-98.8 7000 70000 1000000 500000 <5.4 4-Isopropyltotuene 99-87-6 500 5000 1000000 500000 <5.4 n-Butytbenzene 104-51-8 7000 70000 1000000 500000 <5.4 Naphthalene_ __ ___ 91-20-3 5600 56000 2_500000 1000000 <11 EPA8270E(ug/kgdry) Acenaphthene 83-32-9 8400 84000 2500000 1000000 250 Acenaphthylene 208-96-8 8400 84000 2500000 1000000 <120 Anthracene 120-12-7 40000 400000 2500000 1000000 380 Benzo(a)Anthracene 56-55-3 1000 1000 7800 1000 560 Benzo(a)pyrene 50-32-8 1000 1000 1000 1000 420 Benzo(b)ftuoranthene 205-99-2 1000 1000 7800 1000 560 Benzo(g,h,i)perylene 191.24.2 1000 1000 78000 8400 200 Benzo(k)fluoranthene 207-08-9 1000 1000 78000 8400 220 Chrysene 218-01-9 1000 1000 780000 84000 600 Dibenz[a,hianthracene 53-70-3 1000 1000 1000 1000 <120 Fluoranthene 206-44-0 5600 56000 2500000 1000000 1500 Fluorene 86-73-7 5600 56000 2500000 1000000 200 lndeno[1,2,3-cd)pyrene 193-39.5 1000 1000 7800 1000 170 Phenanthrene 85-01-8 4000 40000 2500000 1000000 1800 Pyrene 129 00-0 4000 40000 2500000 1000000 1100 Naphthalene 91.20.3 5600 56000 2500000 1rX10000 550 SM 2540 G(94)— —— — — — -- Percent Solids TS NA NA NA NA 82 Notes: Report Generated on:6/25/2025 3:13:58 PM Qualifiers: Exceeds CP-51 Criteria' Reported present but not Exceeding CP-51 Criteria= 11111111111111111111111111111 SCALE PURCHASE TICKET PC Metals, Inc. 270 Central Avenue Bridgeport, CT 06607 203-367-9328 Ticket: 599818 Weigh In: 06/20/2025 10.12 Customer: 1034 Weigh Out: 06/20/2025 1016 ENVIRO SHIELD Bridgeport, CT RED RB Commodity Gross Tare Net Price TOTAL$ UNP TANK 12820 12200 620 /GT Buyer: 0 I hereby certify that I have the right to possess and sell this scrap. This is a Bill of Sale to the above described scrap. I hereby acknowledge payment in full. Customer Signature Please do not lose this ticket. Ticket required for payment. ,.t+ won `Oii�:'"+ i -6`: ^u''.[x f�n�:,�_. ''�ks 'y � y.• :•- ..:��i� �':• ��'��ill/i5� '-��ti��+//ii��/� � ��yt��iy�+l��i i!r=. � �=�+'���'/1►�i�,•=r st��'��+��� f �`�i�?�li���r rt { r - __.. -___— -_ _ .___. _,._.�.—. it •.. H N cor O > 4+ G1 N O )}� 40- ej PW w CD ction z W ? ode _ GY _ [:1 4: P o U) � Q o C v „tom r� Y iw NO 0 7— }�s `r ♦i O rA cn y 4 ca O N O I' \4 !<[O)Y `._ i� Zs. If N� isi?;----' ---.i1 1�.�.t"'. ' `�ft��•'' r-�n-"�,*•t;'+j'ji 45,•�%:.�'i� ''+�a4. x ,,ir 1 r. "�' �(ss>►} Jy, ��flrlri� l4���1H��� li�l t i i�fll���.. .'„ vt•i� pt� +i. ?�@Y� ,(•/1 y� q�v .1♦1•.y iyi jy /�(1� - 6 � '!.t/ ♦1�' 1{� jy fF'>'- •fA� � `!.1• `T7A�<�'�� •Y��.!7SAA�� �•• � 'S Ai� �•��S� �it7�Af t�••+ A ,q.�•�� �': iA .� ♦♦ ♦dA ! �C' � .� tN `�' QINib" 1Q_ k• �' �.w� Y✓/,�F(F4{+�jtt lik'� �nv4i O r4" w A a��i.I p .yt� v r...._ "jv�l ?'S:'v 2M ,— lly�1 .Efvj� .- .s/:• •.� DY�'L?._. i. yrtir �6- 3,'r�x,.. fig ,/.�fi.=�'�v ��+T�imi�,y. X' tri�`ti�`A �_•�k � 'M-ri":Jvt r*�''yv�li�-�� "..r.�' �9+ic,6•D'7���'c�1� �.S +)rQ�' rr -`"'�y�,,�3T•' e ENVIINC-01 JSILVA A`�o CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 12/4/2ianoza 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(les)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 Mary Tomaselli Gowrie Group PHONE 70 Essex Road (AIc_No,):(860)399-2838 �F �Nok Westbrook,CT 06498 JFS iiit ss:mtomaselii@risk-strata les.com ­ER(S)AFFORDING COVERAGE _-._ -- _ __- __—__ IUSURE A:Nautilus Insurance Company_ 17370 INSURED Enviroshield Inc.and E.G.Kost Rental,LLC INSURER a:Great Divide Insurance Compan 25224 PO Box 1296 INsuRERc: __- 250 Moffitt Street INSURER 0: _ Strafford,CT 06615 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -- _ -- ILTR NaR TYPE OF INSURANCE N OL SUB POLICY NUMBER POLICY EFF POLICY EXP -- LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE ,�OCCUR ECP01521982-25 12/1/2024 12/1/2025 DAMAG TO RENTED 100,000 Pollution Liability PRAMS S(Eaoccurren0) MED EXP Any one Pe0� 5,000 X -GE i Professional Liab -- -- PERSONAL RADVINJURY S -_ 1,000,000 EWL AGGREGATE LIMIT APPLIES PER: 21000,000 i POLICY a z0f LOC E RAL AGGREGATE._ L—� J PRODUCTS-COMPIOP AGG S 2,000,000 OTHER: --- B AUTOMOBILE LIABILnY— I COMB6\ED SINGLE LIMIT _1,000,000 ANY AUTO BAP1521979-25 12/1/2024 1 12/1/2025 BODILY INJURY r r�erso �n -_ _ 'AUTOS ONLY X AUTOSUIED — (Pe --- BODILY INJURY Per acGden HIR p .pWNEp X MCS-900 E dtY ..X._�AUTOS ONLY ERTY GE — . i I S A UMBRELLA LLAB X OCCUR 1,000,000 EACH OCCURRENCE S __ X Fxc£ss LIAR cLaMs-MADE iFFX 2036752 13 12M 024 12/1/2025 AGGREGATE s - 1,000,000 DED X RETENTIONS 10,000 . B WORKERS COMPENSATION X OTH- PER I AND EMPLOYERS'LIABILITY 57ATIZTE_.�.LI:IZ—, .- WCA 1521980 24 12/1/2024 12/1/2025 I ANY PROPRIETORIPARTNERIEXECUTNE N 1,000,000 OFFICERIMEMBEREXCLUDED7 NIA E,L.EACH ACCIDENT_ I S._.__ 11(yes, (dAandatory inNH) ,_ .L.,DISEASE-_EA FMPLOYE�S 1,000,000 describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Village of Rye Brook is listed as Additional Insured for General Liability where required by written contract. 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. AUTHORIZED REPRESENTATIVE Village of Rye Brook (� 938 King StreetiRye Brook.NY 10573 I7� ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i _ ����Li �� STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF NYS WORKERS' COMPENSATION INSURANCE COVERAGE Ia.Legal Name&Address of Insured(Use street address only) lb.Business Telephone Number of Insured (203)394-2268 Enviroshield,Inc. Post Office Box 1296 lc.NYS Unemployment Insurance Employer Stratford,CT 06615 Registration Number of Insured Work Location of Insured (Only required if coverage is Id.Federal Employer Identification Number of Insured specifically limited to certain locations in New York State, i.e., a or Social Security Number Wrap-Up Policy) 060319014 2.Name and Address of the Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage(Entity Being Listed as the Certificate Holder) Commerce&Industry Insurance Company 3b.Policy Number of entity listed in box"Ia" BAP1521979-25 Village of Rye Brook 938 King Street 3c. Policy effective period Rye Brook,NY 10573 12/1/24 to 12/1/25 3d. The Proprietor,Partners or Executive Officers are ■ included. (Only check box if all partners/officers included) ❑ all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box "Y' insures the business referenced above in box "la" for workers' compensation under the New York State Workers' Compensation Law. (To use this form, New York tNY) must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"T'. The Insurance Carrier will also notify the above certificate holder within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in box "3c", whichever is earlier. Please Note: Upon the cancellation of the workers' compensation policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder, the business must provide that certificate holder with a new Certificate of Workers' Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Vincent M. Falcigno (Print name of authorized representative or licensed agent of insurance carrier) Approved by: Vi—CA-F-M. Fal,ci yvw- 11/25/2024 (Signature) (Date) Title: Managing Member Telephone Number of authorized representative or licensed agent of insurance carrier: (203)745-0078 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2(9-07) www.wcb.state.ny.us Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department,board,commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that compensation for all employees has been secured as provided by this chapter.Nothing herein,however,shall be construed as creating any liability on the part of such state or municipal department,board,commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department,board,commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that compensation for all employees has been secured as provided by this chapter. C-105.2(9-07)Reverse Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Monday,June 16, 2025 1:42 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 06/16/2025 13:33 To: VIL RYE BROOK PRIMARY Transmitted: 06/16/2025 13:41 00001 Ticket: 06165-002-099-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 29 To: Name: HIGHVIEW AVE Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WE ARE REMOVING AN UNDERGROUND TANK LOCATED IN THE FRONT RIGHT OF THE HOUSE NearSt: CRESCENT PL & DIXON ST Means of Excavation: BACKHOE Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: OIL TANK REMOVAL Estimated Work Complete Date: 06/20/2025 Depth of excavation: 7 FEET Site dimensions: Length 6 FEET Width 6 FEET Start Date and Time: 06/20/2025 07:00 Must Start By: 07/07/2025 ------------------------------------------------------------------------------ Contact Name: LEONARD BOCHICCHIO Company: ENVIROSHIELD Addrl: PO BOX 1296 Addr2: City: STRATFORD State: CT Zip: 06615 Phone: 203-380-5644 Fax: Email: len@enviroshield.com Field Contact: LEONARD BOCHICCHIO Alt Phone: 203-380-5644 Email: len@enviroshield.com Working for: PROPERTY OWNER - IRENE MENDICINO ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA/ WSCHSTR CONED NYS THWY AUTH / NY SUEZ WTR WESTCHESTER VIL RYE BROOK 1 Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Wednesday, April 30, 2025 1:20 PM To: Steven Fews Subject: Message from UDig NY ****REGULAR**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 04/30/2025 13:12 To: VIL RYE BROOK PRIMARY Transmitted: 04/30/2025 13:19 00005 Ticket: 04305-001-912-00 Type: Regular Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 29 To: Name: 1/2 HIGHVIEW AVE Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: WE ARE REMOVING AN UNDERGROUND OIL TANK LOCATED IN THE FRONT RIGHT OF THE HOUSE. NearSt: CRESCENT PLACE Means of Excavation: EXCAVATOR Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: N Work Type: OIL TANK REMOVAL Estimated Work Complete Date: 05/30/2025 Depth of excavation: 6 FEET Site dimensions: Length 7 FEET Width 5 FEET Start Date and Time: 05/12/2025 07:00 Must Start By: 05/27/2025 ------------------------------------------------------------------------------ Contact Name: LEONARD BOCHICCHIO Company: ENVIROSHIELD Addrl: PO BOX 1296 Addr2: City: STRATFORD State: CT Zip: 06615 Phone: 203-380-5644 Fax: Email: len@enviroshield.com Field Contact: LEONARD BOCHICCHIO Alt Phone: 203-380-5644 Email: len@enviroshield.com Working for: PROPERTY OWNER ------------------------------------------------------------------------------ Comments: Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA BELL-VALHALLA / WSCHSTR CONED NYS THWY AUTH / NY SUEZ WTR WESTCHESTER VIL RYE BROOK 1