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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.
"Fitle 19 Part 1264 & 1265 NYCRR
To: The Building Inspector of the Village of Rye Brook.
From:
Subject Pr Nrt.: 13 Gardenia Lane SBL: 129.25-1-1.13 Zone: PUD
Please take notice that the subject; dOne or Two Family; ❑ Commercial,
12 New Structure
❑ Addition to an Existing Structure
❑ Rehabilitation to an Existing Structure
to be constructed or performed at the subject property will utilize;
Cr'Truss Tvpe Construction (TT)
YPre-Engineered Wood Construction (PW)
❑ Timber Construction(TC)
in the following location(s);
❑ Floor Framing, including Girders & Beams (F)
❑ Roof Framing (R)
ClFloor 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§t264 for Commercial Buildings,
and NYCRR§1265 for One & Two Family Dwellings.
Date DeF:PlrofDate PrDate TRISHA MARTINEZ
NOTARY PUBLIC-SPATE OF NEW YOPR
No. 0 i MA6331843
Qualified In DutChess County
MY Commtsslon Expires October 19, ?p,