HomeMy WebLinkAboutMP26-010 �yE DR ,l-
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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
January 28,2026
Max Woltshock&Amanda Chiu
67 Rock Ridge Drive
Rye Brook,New York 10573
Re: 67 Rock Ridge Drive, Rye Brook,New York 10573
Parcel ID#: 135.36-1-2
This document certifies that the work done under Mechanical Permit #26-010 issued on 1/21/2026 for the
removal of an above-ground oil tank has been satisfactorily completed.
Sincerely,
Steven E. Fews
Building&Fire Inspector
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'9a2 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 : DATE: Z Oz 4e
PERMIT# MP ISSUED: (& SECT:13S'.S•b BLOCK: l LOT: Z.
LOCATION: ' OCCUPANCY:
❑ Violation Noted THE WORK IS... PASSED ❑ FAILED REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ Natural Gas T 4,
❑ L.P. Gas � �
,a—FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING J l - /
❑ CROSS CONNECTION A k)4LIC �" • 0 ' [C
.FINAL
❑ OTHER
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' BUILDIN :.. MENT
VILLPrE OF RY OOr
9A KING ' ✓ ET RYE BR t ,l` , )573 JAN "s 6
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Application for Permit to Remove or Abandon Fuel Storage Tank
(*Storage Tanks in excess of],100 gallons require registration with the County of Westchester)
FOR OFFICE USE ONLY: PERMIT#: � P -2j-v — T �p
pproval Date: Permit Fee: $
Approval Signature: �'� Other:
Disapproved: 'Z /— Z v Zso
(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: Removal or Abandonment $225.00 per Tank.
5. Dig Safely New York# (dial 81 1):
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, 1 '�.2b 1 e , 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 ( )•Burned in Ground( )
1. Address: (')Q cx=,Q—\C� -e- 'L-t SBL: Zone:
2. Property Owner&Address:
Mi (Z" �
Phone#:�p�lp "'G��`����Cell#: oo email:
3. Contractor&Address: x O e uw CO C)
Phone#: Q� 2`f) �0(0 1S Cell#: 1 email: Y
4. Applicant: `�.b�_r sa 1 -?m-
Phone#: 'Z� C (Q�C-, Cell#: G IL} email:, \C�mac-Im
5. Indicate Fuel Type: Fuel Oil 04•L.P.Gas( )•Gasoline( )•Other( ):
6. Number and Capacity of each Tank: m
7. Exact Location(s)of each Tank: Cl3 6cucs C - �— �MT'R—q,(Wo
1
6/1/2025
STATE OF NEW YOM COUNTY OF WESTCHESTER ) as:
t)orr ,Zia Na2ay' ,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 Removal/Abandonment 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.
3
Sworn to before me this Sworn to before me this
day �V 202� day
I" < vol-1;
Signature of Property Owner Signature pp
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�Iame of Prop wner 1'ri ame of Appl' t
_ blic is
SULEYMA B.SALAZAR SULEYMA B.SALAZAR
Notary Public State of New Ye ary Public-State of New York No.01SA6379344
I Qualified inOWes Westchester County Qualified in Westchester County
T "�p rly completed in its entirety and mus zoz6
slgrrature(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.
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6/1/2025