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BUI MENT _ ---
VIE OK D E C 'E � �� �'
938 KINGB NY 10573
(914)911311, 39-5801 DEC -5 2018
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VILLAGE OF RYE BROOK
FOR OFFICE USE ONLY:
Approval Date: APR 1 7 2019 P -t# P70(o-5 ; Application#
Approval Signature: ARCHITECTURAL REVIEW BOARD;
Disapproved: Date:
BOT Approval Date: Case# : Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
J S Z
Application Fee: I Permit Fees:
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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: S LX1Q'L 105-?'3
2. Parcel ID#: I LC1 •Z% — 1 — I . 10 l Zone:
3. Proposed Improvement(Describe in detail): PJU-1u e 0 1 0 t'l—St"J j Lk— Ayyl 1 t~q PC-r T A Ck ko
n ww L_L_1 til Ll UU I'M hl I Srt W� ►3Rs�C,Y1 k.rJ"r /knl n �►°rt lllL .
4. Prop�erty Owner: SL 2y� I;IWW PA'�Th-}7t L'I'�
ddress: �iVAU.�1�r1'1 G1(LDI.I.P 5 1 tilT/��1�t 01L_ D 5q 11 `t IZy�C LoDk3
Phone# q 14 224 -565U Cell# It 22,4 �.5i)5k* e-mail_1'D1•ca jj'kh1420fl,P,COM
List All Other Properties Owned in Rye Brook:
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# Cell# 914-224-5056 e-mail
c11
6/1/18
I
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: -.eIatA 5NV-0— - 0oen1764&3 i s� c�,� eeM ► i-It0'r ke-AL—
Subject Property: 8 Lavender Lane SBL: 129.25-1-1.102 Zone: PUD
Please take notice that the subject; eOne or Two Family; ❑ Commercial,
eNew Structure
O Addition to an Existing Structure
❑ Rehabilitation to an Existing Structure
to be constructed or performed at the subject property will utilize;
2 rTruss Type Construction (TT)
epre-Engineered Wood Construction (PW)
❑ Timber Construction (TC)
in the following location(s);
❑ Floor Framing, including Girders& Beams(F)
❑ Roof Framing (R)
PI Floor Framing and Roof Framing(FR)
I
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§u64 for Commercial Buildings,
and NYCRR§12.65 for One&Two Family Dwellings.
12-
[)ate lksign Professional
la-3 -1b
Date o y
Date Diary Public
T ISHA MARTINEZ
NOTARY PUBLIC-STATE OF NEW YORK
No. 01 MA6331 e43
Qualified in Dutchess County
My Commission Expires October 19, 2019