HomeMy WebLinkAboutBP19-067PERMIT #�L*
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MENT D u '�7 � r\
VIYE OK 938 KINGB NY 10573DEC - 2018(914) 39-5801 VILLAGE OF RYE BROOK
BUILDING DEPARTI'lENT
***********************************************************************************************************
FOR OFFICE USE ONLY:Approval Date: APR 1 7 ZO z
mit# f 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 -Z
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:
2. Parcel ID#: 1 Zq L5 — I — ! .I y[P Zone: `? .
3. Proposed Improvement(Describe in detail): Nlt-LU C0 NS'I-ELLG'r1 y f1- Si tilt LC- ICAni 'l
r�Tac�� �w��ii�.l�w� Gi�11s�� BEts�crn�.f� �Nn �I�1'i4Rl.1�.
4. Property Owner: et20DL� L-LC-
ddress: LLop ► J f IZ-"ITT 10 t j A I_W 51 114 1 0-V4(- g vv— 1V ki 145�3
Phone# q I'f 2-2 4`5051. Cell# 4i 4 224 -5D51,P e-mail 1Dl t-P OI wA-e°TFt IZOW. OoM
List All Other Properties Owned in Rye Brook: IUD l�-Ik--
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
(I)
6/1/I8
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: Be 1 At-J SH LLL - I Cc 2D7 i Sun l D�GS1 L�f'l PteC N 1 1&6,1 k210--
Subiect Property: 12 Lavender Lane SBL: 129.25-1-1.106Zone: PUD
Please take notice that the subject; PlOne or Two Family; ❑ Commercial,
ffNew Structure
❑ Addition to an Existing Structure
❑ Rehabilitation to an Existing Structure
to he constructed or performed at the subject propert. 3ti ill utili/e,
0 Truss Type Construction(TT)
d Pre-Engineered Wood Construction(PW)
❑ Timber Construction(TC)
in the following location(s);
❑ Floor Framing, including Girders & Beams(F)
❑ Roof Framing(R)
Er 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§1264 for Commercial Buildings,
and NYCRR§1265 for One&Two Family Dwellings.
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Date Notivy—PUblic
TRISHA MARTINEZ
NOTARY PUBLIC-STATE OF NEW YORK
No. 01 MA6331 843
Qualified in Dutchess County
My Commission Expires October 19, 2019