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BUIL , E �13y MENT
VIL E OF RYE OK
938 KIN ET RYE B ,NY 10 (�
(914)9 939-580
�q Qo .org APR 23 2014
VILLAGE OF RYE BROOK
PLUMBING PERMIT APPLICA-+ 'G DEPARTMENT
*MUST BE FILED B Y A LICENSED MASTER PL UMBER ONL Y*
Date: Plumbing Permit";TT>fQ W Building Permit#:
Fee: Approval Signature:
(fees are non-refun able)
Application is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit
to install Plumbing as per detailed statement described below, and in accordance with all applicable Federal, State,
County and Local Codes,at the following location:
Address: 33 V G Ile-y 1 l- 1C R kC Phone#: 3 ? 3 7 ?y
Owner:
Be�e �� _Sc2 L O 'ZD. C O Address & Phone:
Use/Occupancy: Parcel I.D.#: Zone:
LICENSED MASTER PLUMBER'S
INFORMATION:
Name(please print : P�e O e r '/A 8 so Phone#:
Signature: Westchester County License#: y(�
Company Name: S-bn S
Company Address: L i IBC p l'M h z't City/Town: �'
State: _Zip Code: s6 2— Phone#:
......................................................................................
FIXTURES& LINES ARE TO BE INSTALLED ACCORDING TO THE FOLLOWING SCHEDULE:
Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total
Closets Fountains Tubs Tubs Service Service Sewer LP Gas
Basement
1st Floor
2nd Floor
Outside
*Other: Q C k, F-w
Detailed Description of Appliances etc...: / 7 7 2 6 4(C k16
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1982 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 • '` L ' DATE:
PERMIT# �, I C/ C� b �I ISSUED: SECT: BLOCK: :� LOT: c)
LOCATION: r'.__ / �� / OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... 0 ACCEPTED ❑ REJECTED/ REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS
❑ L.P. GAS 5h V�
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER