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TOWN OF EAST FISHKILLBUILDING AND ZONING DEPARTMENT330 Route 376, Hopewell Junction, NY 12533(845) 221-2427 Fax (845) 227-4018http://www.eastfishkillny.govCOMMERCIAL OIL TANK INSTALL / ABANDON OR REMOVEPERMIT REQUIREMENTSInstructions:Please read through this entire application before filling it out. You will need to provide:1.2.3.4.5.Completed application form.Completed tank location survey (see sample)Completed Tank ChecklistProof of Worker’s Comp. Insurance – See attached builder insurance requirements.Liability Insurance – See attached builder insurance requirementsUpon completion of removal:If tank has been removed/abandoned by a tank removal company: A certified letter stating that thework is complete and meets NYSDEC directions must be sent by the oil tank removal company tothe East Fishkill Building Department.If you as homeowner perform the removal/abandonment: You must schedule a final inspection theEast Fishkill Building Department. If you employ sub-contractors, you must ensure that all subcontractors have valid workman’s compensation insurance. (Your homeowner’s insurance may haveprovisions for Workman’s Compensation.) Please call this office at least 48 hours prior to schedulerequired inspections by the building department. Please ensure that your site is ready when youschedule an inspection – an additional charge will apply if an inspector has to be rescheduled due tothe site not being ready at the time of inspection.Additional information could be required at the request of the building inspector.Incomplete applications or poor quality survey drawings will be rejected.Once the permit has been issued, picked up and posted on-site construction may begin.BUILDING PERMITS, CERTIFICATES OF OCCUPANCY AND CERTIFICATES OFCOMPLIANCE WILL NO LONGER BE ISSUED ON ANY PARCELS THAT HAVE ANYVIOLATIONS NOTED OR ANY PERMITS THAT HAVE EXPIRED AND WERE NEVERCLOSED OUT.Town Forms\Commercial Oil Tank 22-03-01Page 1 of 2
BUILDER/CONTRACTOR INSURANCE PROOF REQUIREMENTSPROOF OF WORKERS COMPENSATION AND LIABILITY INSURANCE, NAMING TOWNOF EAST FISHKILL AS ADDITIONAL INSURED, MUST BE PROVIDED BY THE BUILDEROR APPLICANT AT THE TIME THE APPLICATION IS SUBMITTED.LIABILITY INSURANCE CAN BE ON ACORD FORMS WITH “TOWN OF EAST FISHKILL, 330ROUTE 376, HOPEWELL JUNCTION, NEW YORK 12533” LISTED AS ADDITIONAL INSUREDOR CERTIFICATE HOLDER.PROOF OF WORKERS COMPENSATION INSURANCE MUST BE ON NEW YORK STATEFORMS AS STATED IN GENERAL MUNICIPAL LAW SECTION 125.IN THE CASE OF WORKERS COMPENSATION EXEMPTIONSAS OF DEC. 1, 2008 – FORM WC/DB-100 WILL BE RETIRED AND NO LONGER ACCEPTED –FORM CE-200 WILL BE REQUIRED.ALTHOUGH FORM WC/DB-100 WAS VALID FOR MULTIPLE PERMITS THE NEW FORMCE-200 WILL NOT BE.EXEMPTION FORMS WILL NO LONGER HAVE TO BENOTARIZED, OR STAMPED BY THE NYS WORKERS’ COMP BOARD BUT APPLICANTSELIGIBLE FOR EXEMPTIONS MUST FILE A NEW CE-200 FOR EACH AND EVERY NEWOR RENEWED PERMIT. EACH CE-200 WILL SPECIFICALLY LIST THE TOWN OF EASTFISHKILL, THE SPECIFIC TYPE OF PERMIT BEING REQUESTED, THE JOB LOCATIONAND THE ESTIMATED COST OF THE PROJECT. BE SURE THAT APPLICANT HASSIGNED AND DATED THE FORM. EACH CE-200 WILL HAVE A CERTIFICATE NUMBERPRINTED ON IT.FORM CE-200 CAN BE PROCESSED ELECTRONICALLY – SEE THE WORKERS’COMPENSATION BOARD’S WEBSITE, www.wcb.state.ny.us or call (518) 486-6307. ONCETHIS FORM HAS BEEN FILLED OUT & COMPLETED ON-LINE A COPY CAN BE PRINTEDOUT AND THAT COPY CAN BE SUBMITTED WITH THE BUILDING APPLICATION. IFYOU DO NOT HAVE ACCESS TO A COMPUTER, PAPER APPLICATIONS CAN BEOBTAINED AT ANY WORKERS COMP. BOARD DISTRICT OFFICE.Town Forms\Commercial Oil Tank 22-03-01Page 2 of 2
TOWN OF EAST FISHKILLBUILDING AND ZONING DEPARTMENT330 Route 376, Hopewell Junction, NY 12533(845) 221-2427 Fax (845) 227-4018http://www.eastfishkillny.govCOMMERCIAL OIL TANK INSTALL / REMOVE OR ABANDON PERMITDATE:PROPERTY ADDRESS:CITY, STATE, ZIP:PERMIT #:TAX MAP#: ZONE:PROPERTY OWNER’S NAME:OWNER’S STREET ADDRESS (if different):CITY, STATE, ZIP:CONTACT PERSON: PHONE #:TENANT/BUSINESS NAME:STREET ADDRESS:CITY, STATE, ZIP:CONTACT PERSON: PHONE #:CONTRACTOR’S NAME:STREET ADDRESS:CITY, STATE, ZIP:SEE ATTACHED SHEET REGARDING BUILDER/CONTRACTOR INSURANCE REQUIREMENTSIF APPLICANT IS NOT THE PROPERTY OWNER, A LETTER AUTHORIZING APPLICANT TO ACT ON THEIR BEHALFMUST BE SUPPLIED WITH THIS APPLICATION.DESCRIPTION OF WORK TO BE DONE:CONSTRUCTION ESTIMATE: ZBA APPROVAL APPEAL#: DATE:ALONG WITH THE COMPLETED APPLICATION AND A CHECK IN THE APPROPRIATE AMOUNT, MADE OUT TO THETOWN OF EAST FISHKILL, 1 SET OF PLANS AND 1 COPY OF THE PLOT PLAN (IF APPLICABLE) ARE TO BE SUBMITTED.CONSTRUCTION OF 20,000.00 OR MORE REQUIRES STAMPED/SEALED PLANS.I, , HEREBY AGREE TO COMPLY WITH THE PROVISIONS OF THE TOWN OF SAIDSTRUCTURES OF BUILDING, WHETHER STATE, COUNTY OR TOWN.SIGNED:OWNER OR AUTHORIZED AGENTOFFICE USE ONLY:SKETCH/LOCATION TANK: TANK INFO: COMP/LIAB: PRE-INSP DATE:AUTH. LETTER (if required): SIGNATURE OF PERSON TAKING APPL.:THE ABOVE APPLICATION AND ATTACHED PLANS CONFORM TO THE NYS BUILDING CODE AND THE TOWN OFEAST FISHKILL ZONING ORDINANCE. ANY CHANGE IN THE APPLICATION OR PLANS WOULD VOID THISAPPROVAL.DATED:Town Forms\Commercial Oil Tank Installation-Removal Permit 22-03-01SIGNED:BUILDING & ZONING / FIRE INSPECTOR OR DEPUTY
TOWN OF EAST FISHKILLBUILDING AND ZONING DEPARTMENT330 Route 376, Hopewell Junction, NY 12533(845) 221-2427 Fax (845) 227-4018http://www.eastfishkillny.govCOMMERCIAL OIL TANK INSTALL / REMOVE OR ABANDON PERMITTank Location SurveyExisting Oil Tank (to be removed) Location:Check all that apply:Exterior: Interior: Rear: Side:Driveway: Enclosed:Other (explain):Garage:Front: Under Deck:Proposed New Oil Tank (to be installed) Location:Check all that apply:Exterior: Interior: Rear: Side:Driveway: Enclosed:Other (explain):Garage:Front: Under Deck:Town Forms\Commercial Oil Tank Install-Remove-Abandon Permit 22-03-01Page 1 of 2
Tank Check ListINSTALL COMPANY INFORMATION:NAME:ADDRESS:PHONE #:CONTACT PERSON:TANK INSTALL LOCATION:REMOVE/ABANDON COMPANY INFORMATION:NAME:ADDRESS:PHONE #:CONTACT PERSON:TANK ABANDON/REMOVE LOCATION:**SKETCH OF LOCATION AND TANK INFORMATION TO BE PROVIDED.Existing Tank Information: Number of tanks to abandon/remove:Tank Contents: Heating Oil: Diesel Fuel:Tank Size(s):Kerosene:275 gal. 330 gal. 550 gal.Other:1,000 gal. Other:Description of Tank Location:(E.g. three feet from rear of home near left corner, five feet in from edge of driveway)Method of Abandonment: Foam: Sand: Slurry: Removal:New Tank Information:Number of tanks to install:Tank Contents: Heating Oil: Diesel Fuel:Tank Size(s):Kerosene:275 gal. 330 gal. 550 gal.Other:1,000 gal. Other:Description of Tank Location:Tank Material:Are collision poles (bollards) required?: (garage installation)Town Forms\Commercial Oil Tank Install-Remove-Abandon Permit 22-03-01Page 2 of 2
3. Completed Tank Checklist 4. Proof of Worker's Comp. Insurance - See attached builder insurance requirements. 5. Liability Insurance - See attached builder insurance requirements Upon completion of removal: If tank has been removed/abandoned by a tank removal company: A certified letter stating that the
