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VI E OF RYE�JR�OOK
FREVISED AUG _ 2011 38 KING ET RYE BR66k.NY 10573 JUL 13 2017
S (914)939-�
DATED: wH'' ekor VILLAGE OF R•rE BROOK
BUILD11\1G DEPARTMENT
FOR OFFICE USE ONLY:
Approval Date: 2QU Permit # -7 Application#
Approval Signature: ARCHITECTURAL REVIEW BOARD:
Disapproved: : Date:
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
Application Fee: Permit Fees: t 2 z 5 7`
EXTERIOR BUILDING PERMIT APPLICATION
Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below.
1. JobAddress: 61 HDtaE_-1$LL OF L-f'J/, "E 1814001-1-NU
2. Parcel ID#: Zone: �cJ�
3. Proposed Improvement(Describe in detail):KA=phi (/)N)STIZ�X�(�1V - S)N61 Yt/111�I t4'TT/3�ktE1�
pvvGtU tin, wt i" ftA GY4, AOC:
4. Property Owner: 5C. 12y.E &2=jDC1L p�p�I\.E� I L C
Addre��riE►"fw'IAyxn 6W10 hP .5/Arr-72AdV10Ngt_t -W_--' S, is fit- l_I�lo 1��1L�N`/ /OS'�
Phone#9/1/ 2 _4 SZISlo Cell# 914 22-4 5zS'-(,' e-mail�11a�stt�S�1.���k�vv►�le�,y'cp.t,t
List All Other Properties Owned in Rye Brook: 1l t�l
Applicant:
Address:
Phone# Cell# e-mail
Architect:
Address:
Phone# Cell# e-mail
Engineer:
Address:
Phone# Cell# e-mail
General contractor: SC Rye Brook Partners LLC - Jeff DuBois
Address: 5 International Drive Suite 114, Rye Brook NY 10573
Phone# Ccll N 914-224-5056 e-mail
(I)
12.8.16
This form must be properly completed & notarized by the Design Professional of
record and the Property Owner. Failure to provide this completed form with your
permit application will delay the permitting process.
Notice of Utilization of Truss Type, Pre-Engineered Wood,
or Timber Frame Construction.
Title 19 Part 1264 & 1265 NYCRR
To: The Building Inspector of the Village of Rye Brook.
From: 62-11`Yn.l Sktl�— CnI Q—FSe-h) It--SA C-N) ig 2.6r^t I"
9 Honeysuckle Lane
Subject ProWrt : )Zq . 2_!�—_ )—)- '2_- - SBL: 129.25-1-1.28 Zone: PUD
Please take notice that the subject; Ef"One or Two Family; ❑ Commercial,
t"New Structure
❑ Addition to an Existing Structure
❑ Rehabilitation to an Existing Structure
to be constructed or performed at the subject property will utilize;
I-Truss Type Construction (TT)
i(Pre-Engineered Wood Construction (PW)
❑ Timber Construction (TC)
in the following location(s);
❑ Floor Framing, including Girders & Beams (F)
❑Roof Framing (R)
D Floor Framing and Roof Framing (FR)
Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or
building utilizing truss type, pre-engineered wood, or timber construction must be posted with a
Truss Identification Sign, installed in conformance with NYCRR§1z64 for Commercial Buildings,
and NYCRR§1u65 for One&Two Family Dwellings.
-7 10�1-7 Ajv�
Design fessional
Date Propc
C n �3 2-0 1-1 - ---
Date rc
Michelle Diane Gironda
NOTARY PUBLIC,STATE OF NEW YORK
Reg No.01 G 16301231
Qualified in Westchester County
My Commission Expires 04114/_018