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BUILDING.DEPARTMENT ECENED
Vn. .AGE OF RYE.BROOK SEP 15 2025
938 KING TR 'ET RYE BROOK,NY 1 H
(914)?39-0668 VILLAGE OF RYE BROOK
www.rArookny.eov BUILDING DEPARTME;JT
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#: 4�— 3
Approval Date: Permit Fee: $
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BFEN ISSUED BY THE BUILDING
INSPECTOR THE ♦DMINISTRA'I'IVF FEF FOR WORK PROGRESSED OR COMPLETED`%*m10tJT A PERNIFI IS
12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF S750.00
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: Installation: $185.00 per Tank.
5.Dig Safely New York#(dial 811):
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 hellrein scribed.The applicant and property owner,by signing this document agree that the subject fuel tank(s)
will be installed in conformance with all applicabl Village,County,State&Federal laws,codes,rules and regulations.
Indicate Permit Tyne: Above Ground( • Buried in Ground ( )
I. Address: 58 Talcott Road SBL. 135-50-1-19 zone: '
2. Property owner&Address: Tatyana Tatarskaya, 58 Talcott Rd., Rye Brook, NY
Phone#: 347-409-3853 Cell# email: STATARSKAYA@GMAIL.COM
3. Contractor&Address: 1 Gateway Plaza 4th fir, Port Chester, NY 10573
Phone#: 914-847-0295 _Cell#: _ Cmail: jweir@robisonoil.com
4. Applicant: Meenan Oil Co LP
Phone#: 914-847-0295 Cell#: email: jweir@robisonoll.eom
5. Indicate Fuel Type:Fuel Oil L.P.Gas( )•Gasoline( )•Other( ):
6. Number and capacity of each Tank: Installation of new 275 gallon Granby Ecoplus tank
7. Exact Location(s)of each Tank: Under deck crawl area.
t
6/1/2024
�AT NE YORK. OUN WESTCHESTER ) as:
ing duly sworn,deposes and states that he/she is the applicant above named,
(print nan f individual�g�ing as UV
�pp1i t)
and further states that(s)he is the Tank Installation Contractor for the legal owner and is duly
authorized to make and file this application.
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 they it j BYc1ir+Wk and all other applicable laws,ordinances
FM
and regulations. Notary Public,State of New York
NO.OIC10020948
Sworn to before me this QualifW In Westchester o fore e this
Q. Commission Expires 02/
day of .20 day of 20 _
To� 7a'
Signature of Property Owner Si n lure of Applicant
Print Name of A icant
Print Name of Property O n 1?
Notary"he 0
R M.kUL o ry Public
ESTHE tax
00TARY PUBLIC. au n
No,o1R�3s Count)
;ified in King 1
(lua ,mires M""6.
This applicatignitt"M 8' 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
6/l/2024