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HomeMy WebLinkAboutMP26-004 l? BR t G VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914)939-0668 Christopher J. Bradbury www.ryebrooknKQov TRUSTEES BUILDING& FIRE INSPECTOR Susan R. Epstein Steven E. Fews David M. Heiser Donald T.Krom,Jr. Salvatore W. Morlino CERTIFICATE OF COMPLIANCE January 20,2026 112 BHL LLC 112 Brush Hollow Lane Rye Brook,New York 10573 Re: 112 Brush Hollow Lane, Rye Brook,New York 10573 Parcel ID#: 129.76-1-148 This document certifies that the work done under Mechanical Permit #26-004 issued on 1/9/2026 for the installation of new above-ground oil tank has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to cu � lj �O BUILDING DEPARTMENT LDINGINSPECTOR 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 :—� &- a w- - 3 DATE: /- ' S-— Z Z- Y� PERMIT# � a - 00_ ISSUED:•I'q-4,_ SECT:124-26 BLOCK: LOT: �7 LOCATION: •VcW 1, c -4t1- OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... L`7 ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION �J ❑ NATURAL GAS p L.P. GAS FUEL TANK ex r ❑ FIRE SPRINKLER S ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER yV M Q ss , Yy I Y•, 1� L ,� r F � II CETVE O DD _7,BUILENT VIL JAN O 2026 938 KINGNY 10573 VILLAG ' r RYE BROOK ov 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#: I" f7 2(p 6U 4 Approval Date: 1��-\2 Permit Fee: $ 22 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: Installation: $225.00 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 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 Tvae: Above Ground �-Buried in Ground ( ) l. Address: 112 Brush Hollow Lane SBL: 129.76-1 _ Zone: J 2. Property Owner&Address: 112 BHL LLC 112 Brush Hollow Lane Rye Brook NY 10573 Phone#: 914-565-0665 Cell#: email: danielmbergerl7@gmail.com 3. Contractor&Address: Innov8tive Environmental Services 392 Columbus Ave Valhalla NY 10595 Phone#: 914449-6608 Cell#: email: service@innov8enviro.com 4. Applicant: Innov8tive Environmental Services 392 Columbus Ave Valhalla NY 10595 Phone#: 914-449-6608 Cell#: email: service@innov8enviro.com 5. Indicate Fuel Type:Fuel Oil( )•L.P.Gas( )•Gasoline( )•Other( ): 6. Number and Capacity of each Tank: Installation of(1)220 Gal Aboveground Storage Tank 7. Exact Location(s)of each Tank: Storage shed at rear of property t 6/1/2025 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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 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 the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this Llir& Sworn to before me this day of c�()AAA ,20 VQ _ ,20 � l Btu Signature of P► perty Owner Signature of Applicant Daniel M Berger for 112 GHL LLC Donald Feengy P 'n ame of Property O n t Name of Applic t 19 NORINE NORINE MEYER Notary Public Notary Public, �elho �otary Public,State of New York Lic.No.01 ME6130833 Lic.No.01 ME6130833 Qualified In Westchester Cou oualified in Westchester Countya Commission Expires July 25, t 2Q��� F Commission Expires July 25, This application must be properly comp ete 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 6/1/2025 The Arbors Homeowners' Association 173 '/2 Ivy Hill Crescent Rye Brook, NY 10573 January 12th, 2026 112 BHL LLC — Dan Berger 112 Brush Hollow Lane Rye Brook, NY 10573 Re: Above Ground Oil Tank Install oil Tank in Shed Dear Dan, The Architecture and Grounds Committee (A&G) and the Board has reviewed your application for the above-named work. The approval requires that you restore any common property that is damaged when doing the work. This project requires a permit from The Village of Rye Brook. You are approved to get a permit from the Village of Rye Brook. You are directed to submit this letter to the Village along with your permit application. Once the permit is obtained, a copy must be provided to A&G. Work on the project may not begin until you receive written notice of receipt of your permit from A&G. If any changes are made to the original plans submitted to A&G, due to input from the Village or arising during construction, the Committee must be notified in writing. Work cannot proceed until you receive written approval for those changes. Failure to comply with these procedures will result in fines and/or work stoppage. If you have any questions, please contact me at: Property Manager. Sincerely, Nicholas Salzarulo Property Manager i Y azi O LLJ N fn o l LL!x �U- Z cry O a w L Y c' o �� m m Q _J X N N O 1 �V �pil > 0 O u O o —_ O ' ¢ O 00 4 O 0 2 z LA cu u I N f0 C QJ N � vU-) -- -- . . o > c LU 1] } v E z 7 00 O - > U 9 O N L C O) M > Standard n Standard oil tank with strong welded lap joints "l SAFETY Bottom outlet configuration allows for natural elimination of water build- up from condensation DUIIAQUTY Electrostatic powder-coated paint Made of robust material PEACE OF MIND 10 years against manufacturing defects('See warranty certificate for details.) Contractordrlendly.trouble free Installation a 2D9101 120 Vertical 12 47'/23'/30' 170 208101 138 Ve-1,;a:: 12 44'/27'/30" 160 208601 13H Ac 7"ta'. 12 27"/"'/30" 160 207101 220 Stubbies/Vertical 12 44"/27'/48" 220 2032016 230 Thin/Vertical grey 12 44"122"/60" 235 203701 G 230 Thin/Horizontal grey 12 22"/44"/60' 235 202201 240 Narrow/Vertical 12 47'/23'/60' 265 202701 240 Narrow/Horizontal 12 23"/47'/60" 265 204201 275 Vertical 12 44"l27"160' 255 204701 275 Horizontal 12 27"/44'/60' 255 211201 275 Vertical 10 44"/27"160" 330 211701 275 Horizontal 10 27"144"/60" 330 205201 330 Vertical 12 44"/27"/72" 290 205701 330 Horizontal 12 27"/44"/72" 290 �V - � � ���;tiy �y�4�ti�trt�;y f ,ti,5�i,r�� �yy�;1•Nf r ay(y'I�; ll�1,y .. � a.'"'. `"" i fllt r� O '. ti 4 ti&1 .�g oy�`� `��.,. t .,O Ir F1,ti�} 0g�,. i '•l��{A1'F;'AR � . Ric .��1 Sy f �rHi ♦♦ v •• i�r Lit R •Ar d)� i 'p '�`4• >s 1 1 If +1 - tN/f 1 t �r' 1 �! _ 1:.1 'ifjl////1 - 111/// if 1 Mi �(0)>/h=� tis�{-11�11 .=a ... -a rl�`►/t _�,i s \11�111/•+z_. rt41.�llllr� ,.'�+1+1�111 1+ /1 _ -\11/� '.. O i � y L L y W U') 'ev E c a - M 1 O r U U 'O p <css» L v „ W ar ..Vr W O i w • <(ss» G� �6.o J W o .O y tQCt10Q W Z) Z Q o . W ch ] G teas» co O \ •r i�.j �j > . •� CC M+I . co � O is,V* U • nfre•1 � J U .�`. �et:•r 3 a ,�co»j t •� J� AC RO OP CERTIFICATE OF LIABILITY INSURANCE rATE(MM/DD/YYYY) �/ 2/19/2025 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 Mt Pleasant Capacity PHONE Evita Grande FAX P.O. Box 1689 (A/c No t)• 914-205-7682 A/c No):914-205-7682 Pearl River NY 10965 ADDRESS: Evita.Grande@mtpcap.com INSURERS AFFORDING COVERAGE NAIC q INSURER A:Century Surety Company 36951 INSURED INNOENVI INSURERB: Selective Way Insurance Company 26301 Innov8tive Environmental Services Inc. 392 Columbus Ave INSURERC: Valhalla NY 10595 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:284037213 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 SUBR POLICY NUMBER MM/D CY EFF POLICY FXP LTR D/YYYY MMIDD/YYYY LIMtTS A X COMMERCIALGENERALLIABILITY CCP1289339 2/14/2025 2/14/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RNTED CLAIMS-MADE FX_1 OCCUR ✓ PREMISES EaE occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY❑PET 7 LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER $ AUTOMOBILE LIABILITY S264364200 1/15/2025 1/15/2026 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 I X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLA LIAB X OCCUR CCP1289340 2/14/2025 2/14/2026 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A I Pollution Liability CCP1289339 2/14/2025 2/14/2026 Each claim 2,000.000 Professional Liability Aggregate 2,000,000 Limit 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/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 Rye Brook, NY 10573 AUTHORIZED REPRESENTATIVE Vi�C J✓Ct�a. 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) 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) o. -W 'a ^^^^^^ 824703808 MT PLEASANT CAPACITY AGENCY 'iimd , 1 BLUE HILL PLAZA STE 1689 PEARL RIVER NY 10965 ❑�.��J� SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER INNOV8TIVE ENVIRONMENTAL VILLAGE OF RYE BROOK SERVICES INC 938 KING STREET 392 COLUMBUS PLAZA RYE BROOK NY 10573 VALHALLA NY 10595 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE W2455 047-7 931427 10/02/2025 TO 10/02/2026 10/7/2025 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://WWW.NYSIF.COMICERT/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: 621990673 U-26.3