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AS-BUILTIFINAL SURVEY
REQUIRED PRIOR TO
FINAL INSPECTION
FINISHED BASEMENT NOT
APPROVED FOR USE AS A
SEPARATE APARTMENT OR
DWELLING UNIT
THIS BUIIDMG MUST BE PDSTED
WITH A PERMANENT COMSTRUCIION
TYPE IDEMIFICATION SWft
v
FR
DRIDA lU THE ISSUANCE OF A C/0,
AS REQUIRED BY NY STATE LAW.
BUIL DBR
ENT D �/
VI E OK
938 KING ET NY 10573 JUL 16 2018
(914)99-5801
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
Approval Date:J UN 1 8 2019 Permit# I Application#
Approval Signature: ARCHITECTURAL RE BOARD:
Disapproved: Date:
BOT Approval Date: Case# : Chairman:
PB Approval Date: Case# : Secretary:
ZBA Approval Date: Case#
Other:
Application Fee: ` Permit Fees.
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: I'i LAVer,11Dke- t24k B2Ltv- N4 1657:f3
2. Parcel ID#: 12q Z5 1 — I )13 Zone:
3. Proposed Improvement(Describe in detail): 161tW eVMS-o-Z LtC i r DAJ — SJ Lti rAIYl►L4 A—, rK AWa1 )
-Dwkt.l,IN� wr�Lt G�tiiiSrtkr� gASrtm��fT �n-in GJr�P1a�� .
4. Property Owner: S C !2 4 k g2UC 1� ;P�eTti k QS, L t-C
Address:lW b Q_A 10 IleD Pt R 5 1 ni 1-4 D12,Sir I I't 1 (L44 l32G�� IJ y I b 533
Phone# A 14 2 2 4-505(o Cell# GI 14 2 2-4-rjD51.. e-mail I D"OD I S
List All Other Properties Owned in Rye Brook: N�N�-
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
5. Occupancy,(l-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: Post-construction:
6. Area of lot: Square feet: lf(p 12- Acres: - 16 $
7. Dimensions from proposed building or structure to lot lines: front yard: 1S _- rear yard: _ �
right side yard: C> left side yard: 1� _other:
8. If building is located on a corner lot,which street does it front on:
9. Area of proposed building in square feet: Basement: -35G 1-fl: I '1 -_2"d fl: (1 JZ- Yd fl: _
10. Total Square Footage of the proposed new construction: 3b2 1i 38 1 S a, T
1 I. For additions,total square footage added:Basement: 11 fl: 2"" fl: tl:
12. Total Square Footage of the proposed renovation to the existing structure: _
13. N.Y.State Construction Classification: N.Y.State Use Classification: I Grit M I Ly
14. Number of stories: Z Overall Height: 3 D t C'I Median Height: 3: r 10 tt
15. Basement to be full,or partial: I?Fte 1 I rq L finished or unfinished: ll�6 t-,S I sA4 k-D
16. What material is the exterior finish: 01l1V1 r'J 1�l i}IJk-
17. Roof style;peaked,hip,mansard,shed,etc: PkAdi"D f KLA-r Roofing material: AS'PHA L r
18. What system of heating: ('D e e kp k l DT P1 112-
19. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this
application.
20. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression
system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) Yes: / No:
(f yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
21. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a
Stormwater Management Control Permit as per§217 of Village Code? Yes: '/ No: Area:
22. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
Yes: 1 No: (fyes,applicant must submit a Site Plan Application,&provide detailed drawings)
23. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No:
(fyes,you must submit a Site Plan Application,&provide a detailed topographical survey)
24. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No:
(f yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan)
25. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No:
(if yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan)
26. Will the proposed project require a Tree Removal Permit as per§235 of Village Code? Yes: I/ No:
(rf yes,applicant must submit a Tree Removal Permit Application)
27. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No:
Indicate: TIER I: TIER II: TIER III: (if)vs,a Home Occupation Permit Application is required)
28. List all zoning variances granted or denied for the subject property:
29. What is the total estimated cost of construction: S 3 41 1319 -cc) Note:The estimated cost shall
include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,including any material and labor which may
be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO.
30. Estimated date of completion:
(2)
6/1/18
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: Z2l tti-� e�-
Subject Property: 19 Lavender Lane SBL: 129.25-1-1.113Zone: PUD
Please take notice that the subject; YOne or Two Family; ❑ Commercial,
eNew Structure
❑ Addition to an Existing Structure
❑ Rehabilitation to an Existing Structure
to he constructed or performed at the subject propert- mvill utilize;
eTruss Type Construction(M
•Pre-Engineered Wood Construction(PW)
❑ Timber Construction(TC)
in the following location(s);
❑ Floor Framing, including Girders & Beams (F)
❑ Roof Framing(R)
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§tz65 for One&Two Family Dwellin s.
Date Designr7�__
"1 ) 9 1 �"
Date y
Date Notary Public