HomeMy WebLinkAbout02.04.2020 Exterior Building Permit3/21/19
EXTERIOR
BUILDING PERMIT INSTRUCTIONS & PROCEDURES
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET, RYE BROOK, NY 10573
PHONE (914) 939-0668 FAX (914) 939-5801
www.ryebrook.org
Applicants seeking an exterior building permit must first obtain approval from the Village of Rye Brook Architectural Review
Board (ARB). A representative of the applicant must be present at the ARB meeting which is held on the 3rd Wednesday of every
month, 7:30 p.m. at Village Hall in the main meeting room. Applications must be submitted to the Building Department by no later
than the 1st Wednesday of the month in order to be considered for that month’s agenda. Please note that the agendas are limited to
ten (10) applications per month. Once your application receives ARB approval, it must then be reviewed by the Building Inspector
for compliance with all applicable state and local building codes, and for issuance of the permit.
DO NOT START CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.
THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS
12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF $750.00 & A MAXIMUM OF $6,000.00
APPLICANT’S INITIAL SUBMISSION TO THE BUILDING DEPARTMENT MUST INCLUDE:
1.A properly completed application with notarized signatures where indicated.
2.Application filing fee: Residential = $75.00 / Commercial = $250.00 (Application fees are non-refundable)
3.Completed & Signed Application Check List
4.Two (2) sets of dimensioned plans, (one full size {maximum allowable plan size = 36” x 42”} and one 11”x17”), depicting the
location of all existing and proposed buildings and/or addition, alteration, repair, including proposed elevations & floor
plans and all existing and proposed property setbacks. Plans must be signed & sealed by a NY State Registered
Architect or NY State Licensed Professional Engineer.
5.Two (2) copies of a recent survey of the subject property. (one full size {maximum allowable plan size = 36” x 42”} and one
11”x17”) [A topographic survey is required for any proposed re-grading or work in a steep slope as defined by Village Code]
6.Photographs showing front & side views of the existing property as well as photographs of properties on either sides
and across the street.
7.Samples of Materials and Finishes. (Sample boards may be presented at the meeting)
8.One electronic (disc) copy of all materials submitted.
FOLLOWING APPROVAL BY THE ARB, THE APPLICANT MUST SUBMIT THE FOLLOWING:
1.Full payment of the building permit fee. (see permit fee schedule on the following page)
2.Your contractor’s valid Westchester County Home Improvement License.
3.Your contractor’s valid proof of liability insurance. (Village of Rye Brook must be listed as certificate holder)
4.Your contractor's valid proof of workers compensation insurance.
(Form # C105.2 or Form # U26.3 / or NY State Workers Compensation Waiver)
5.The “Call Before You Dig” (code 53) Number.
6.Two (2) sets of sealed construction drawings; (one full size {max. allowable plan size = 36” x 42”} and one 11”x17”),
7.Fire sprinkler systems are required for all new buildings, for additions & alterations to commercial buildings and when
finishing a third (3rd) floor in a 1 or 2 family dwelling. Any installations of a new, or modification to an existing fire
suppression system, (fire sprinkler system, ANSL system, FM-200 system, Type I Hood, etc…) require a separate
Automatic Fire Suppression System Permit application & two (2) sets of engineered plans. Fire sprinkler plans must be
approved by the Building Inspector prior to the issuance of any permit, and Westchester County Department of Health
approval is required for the fire sprinkler system’s backflow prevention device.
I
3/21/19
BUILDING PERMIT FEE SCHEDULE:
Commercial: $22.00 / $1000.00 of construction cost with a minimum fee of $250.00.
Residential: Fee A For new construction/additions less that 800 sq. ft. in size and alterations,
decks, patios or other work: $15.00 / $1000.00 of construction cost with a minimum
fee of $100.00.
Fee B For new construction/additions 800 sq. ft. in size or greater;
Total Gross Floor Area x $225.00 x $15.00 / $1000.00 plus any alteration fees from
Fee A above.
EXPIRATIONS, CODES & REGULATIONS:
“A building permit application that is dormant or otherwise inactive shall be deemed abandoned twelve months after
the date of its submission to the building department.”
(§91-2.1. Code of the Village of Rye Brook)
“A building permit shall expire six months after its date of issuance if construction has not commenced. If
construction has commenced within the six month period as set forth in this subsection, the building permit shall
expire 12 months after its date of issuance if all of the proposed work has not been completed or a temporary
certificate of occupancy has not been issued. Construction shall be deemed to have commenced when significant
construction work on the project, as described on the building permit, has been performed. The Building Inspector
shall have the authority to determine whether construction has commenced, and his or her decision shall be final.”
(§91-2.b. Code of the Village of Rye Brook)
Please note that should you fail to properly close out your permit prior to the expiration date in accordance with
the law, you will be liable for the $500.00 Administrative Fee in connection with all expired Building Permits
issued after January 1, 2003. Please note that this Administrative Fee applies to each individual permit and must
be remitted in addition to any other required fees associated with closing the permit, as well as any court imposed
fines should a summons be issued.
HOURS FOR OPERATION OF CONSTRUCTION EQUIPMENT
Weekdays: 8:00am to 6:00pm or dusk, whichever is earlier
Saturdays: 9:00am to 4:00pm.
Sunday & Holidays: NO CONSTRUCTION ACTIVITY ALLOWED (Holidays Include: News Year Day, January 1st;
President’s Day, 3rd Monday in February; Memorial Day, last Monday in May; Independence Day, July 4th; Labor Day, 1st Monday in
September; Thanksgiving Day, 4thThursday in November; Christmas Day, December 25th; when the holidays set forth fall on a Sunday, the
holiday is observed the next day). (§158-4. Code of the Village of Rye Brook)
It shall be the responsibility of the applicant, owner, or person in responsible charge to notify the Building
Department at least 48 hours in advance to schedule all required inspections for site work, footings, foundation,
drainage, framing, plumbing, electrical, fire blocking, fire suppression, insulation, final or any other required
inspection.
Please note that electrical inspections are performed by the Village’s third-party electrical inspection agency and must
be scheduled by your licensed electrician. Electrical certificates, C/O application & fees and the final survey must be
submitted prior to scheduling the final inspection.
“It shall be unlawful for an owner to use or permit the use of any building or premises or part thereof
hereafter created, erected, changed, converted or enlarged, wholly or partly, in its use or structure until a
Certificate of Occupancy shall have been issued by the Building Inspector”
(§250-10.A. Code of the Village of Rye Brook)
Please keep these instruction sheets throughout the duration of the job for reference.
II
3/21/19
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK, NY 10573
(914) 939-0668 FAX (914) 939-5801
www.ryebrook.org
***********************************************************************************************************
ARCHITECTURAL REVIEW BOARD CHECK LIST FOR APPLICANTS
This form must be completed and signed by the applicant of record and a copy shall be
submitted to the Building Department prior to attending the ARB meeting. Applicants
failing to submit a copy of this check list will be removed from the ARB agenda.
Job Address:___________________________________
Parcel ID #:_______________________Zone:________
Proposed Improvement (Describe in detail):
_____________________________________________
_____________________________________________
_____________________________________________
Property Owner:________________________________
Address: ______________________________________
Phone #_______________________________________
Applicant appearing before the Board:
_____________________________________________
Address:______________________________________
Phone #______________________________________
Architect/Engineer: _____________________________
Phone #_______________________________________
Date of Submission: _____________________________
APPLICANT CHECK LIST:
MUST BE COMPLETED BY THE APPLICANT
The following items must be submitted to the Building
Department by the applicant - no exceptions.
1. ( ) Completed Application
2. ( ) Two (2) sets of sealed plans. (one full size {maximum
allowable plan size = 36” x 42”} and one 11”x17”)
3. ( ) Two (2) copies of the property survey.
4. ( ) Two (2) copies of the proposed site plan.
5. ( ) One electronic/disc copy of the complete
application materials.
6. ( ) Filing Fee.
7. ( ) Any supporting documentation.
8. ( ) HOA approval letter. (if applicable)
9. ( ) Photographs.
10.( ) Samples of finishes /color chart. (a sample board or
model may be presented the night of the meeting)
By signature below, the owner/applicant acknowledges that he/she has read the complete Building Permit
Instructions & Procedures, and that their application is complete in all respects. The Board of Review reserves the
right to refuse to hear any application not meeting the requirements contained herein.
Sworn to before me this ______________ Sworn to before me this ______________
day of _________________, 20_____ day of _________________, 20_____
______________________________ ______________________________
Signature of Property Owner Signature of Applicant
______________________________ ______________________________
Print Name of Property Owner Print Name of Applicant
______________________________ ______________________________
Notary Public Notary Public
III
900 King Street
129.68-1-13 PUD
Demolition of existing office building and redevelopment
of site with Senior Living Facility.
900 King Street Owner, LLC
200 Madison Avenue, 26th Floor, NY, NY 10016
212-481-1122
Veneziano & Associates
84 Business Park Drive,Suite 200, Armonk
914-273-1300
JMC
914-273-5225
February 4, 2020
X
X
X
X
X
X
X
3/21/19
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK, NY 10573
(914) 939-0668 FAX (914) 939-5801
www.ryebrook.org
***********************************************************************************************************
FOR OFFICE USE ONLY:
Approval Date: __________________ Permit #_________________ 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: __________________ _____________________________________
***********************************************************************************************************
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#:____________________________________________________________ Zone: _________________________
3. Proposed Improvement (Describe in detail): ________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
4. Property Owner: ___________________________________________________________________________________________________________
Address: ____________________________________________________________________________________________
Phone #___________________________Cell #_____________________________ e-mail __________________________
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: ___________________________________________________________________________________
Address: ____________________________________________________________________________________________
Phone #____________________________Cell #_____________________________e-mail __________________________
(1)
February 4, 2020
900 King Street
129.68-1-13 PUD
Demolition of existing office building and redevelopment of Site with
Senior Living Facility.
900 King Street Owner, LLC
200 Madison Avenue, 26th Floor, NY, NY 10016
212-481-1122
Perkins Eastman Architects, PC
422 Summer Street, Stamford, CT 09601
203-251-7400
JMC
120 Bedford Road, Armonk, NY 10504
914-273-5225
3/21/19
5. Occupancy; (1-Fam., 2-Fam., Commercial., etc…)Pre- construction:________________ Post-construction:_________________
6. Area of lot: Square feet:_____________________________________________ Acres:_____________________________
7. Dimensions from proposed building or structure to lot lines: front yard: _________________ rear yard: ________________
right side yard: __________________ left side yard: _________________ 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: _________ 1
st fl:__________ 2nd fl:____________ 3rd fl: ___________
10. Total Square Footage of the proposed new construction: _______________________________________________________
11. For additions, total square footage added: Basement: _________ 1
st fl:__________ 2nd fl:____________ 3rd fl:____________
12. Total Square Footage of the proposed renovation to the existing structure: _________________________________________
13. N.Y. State Construction Classification: _____________________ N.Y. State Use Classification: ______________________
14. Number of stories: ___________________ Overall Height:___________________ Median Height: ____________________
15. Basement to be full, or partial: _________________________, finished or unfinished: ______________________________
16. What material is the exterior finish:_______________________________________________________________________
17. Roof style; peaked, hip, mansard, shed, etc: _________________________ Roofing material:_________________________
18. What system of heating:________________________________________________________________________________
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: _____
(if 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: ______ No: ______ (if yes, 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: ______
(if yes, 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: ______
(if 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: ______ No: ______
(if 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 yes, 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: $______________________________________ 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 C/O.
30. Estimated date of completion:__________________________________________________________________________
(2)
Office Senior Living
773,908 sf 17.77 ac
42'30'
330'248'
TBD TBD TBDTBD
355,902 GSF
TBD TBD
41.81'2 / 3 / 4
TBD TBD
TBD
TBD TBD
TBD
X
X
X
X
X
X
X
X
TBD
TBD
3/21/19
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK, NY 10573
(914) 939-0668 FAX (914) 939-5801
RESIDENTIAL LOT AREA COVERAGE
Address: Section: Block: Lot: ______ ___
PERMITTED COVERAGE RATIOS IN RESIDENTIAL DISTRICTS (Local Law 3-88)
Existing: Proposed:
1. AREA OF LOT Sq. Ft. Sq. Ft.
2. AREA OF HOUSE
a. Coverage of Main Building
(Including Attached Garage or Accessory Building) Sq. Ft. Sq. Ft.
b.Area of 1st Floor Divided By Area of Lot x 100 % %
3. AREA OF ACCESSORY BUILDING
(Includes Detached Garages, Tool Shed, Playhouses) Sq. Ft. Sq. Ft.
a. Coverage of Accessory Building
Area of Accessory Building Divided By Area of Lot x 100 % %
4. AREA OF DECK Sq. Ft. Sq. Ft.
a. Coverage of Deck
Area of Deck Divided By Area of Lot x 100 % %
I attest to the best of my knowledge and belief, the above information is correct.
_____________________________
Architect’s Signature
(3)
YOUR
ZONE
(CHECK)
ZONE
DISTRICT
AREA IN
SQ. FEET
MAIN
BLDG.
MAX.
ACCESS.
BLDG.
DECK
MAX.
R-35 35,000 14% 4% 5%
R-25 25,000 14% 3.5% 4%
R-20 20,000 14% 3.5% 4%
R-15 15,000 16% 3.5% 4%
R-15A 15,000 12% 3.5% 4%
R-12 12,500 17% 4% 4%
R-10 10,000 20% 4.5% 3.5%
R-7 7,500 23% 4.5% 3.5%
R-5 5,000 30% 5% 3.5%
R-2F 5,000 30% 5% 3.5%
900 King Street 129.68 1 13
773,908 773,908
2.19 ac 2.93 ac
12.22 16.49
(all buildings proposed)
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK, NY 10573
(914) 939-0668 Fax (914) 939-5801
IMPERVIOUS COVERAGE RATIOS RESIDENTIAL DISTRICTS
Address: Section: Block: Lot:________Zone: _
IMPERVIOUS SURFACES (Definition): All buildings, as defined herein, and all areas on the ground or elevated above
the ground which are comprised of materials through which water cannot readily flow, including, but not limited to
asphalt, concrete, masonry, wood, gravel and clay, and which consist of elements including, but not limited to, court
yards, sports courts, swimming pools, patios, sidewalks, ramps, terraces and driveways.
*”Base Lot Area” is the minimum end of the lot size
range in the “Lot Area” column
I attest to the best of my knowledge and belief, the above information is correct.
_____________________________
Architect’s Signature
(4)
3/21/19
LOT AREA
(sq.ft.)
TOTAL MAXIMUM PERMITTED
COVERAGE
BY IMPERVIOUS SURFACES
For Base Lot
Area (sq.ft.)*
For Lot Area
Over Base
Lot Area (%)
0 to 4,000 0 55
4,001 to 6,000 2,200 35
6,001 to 12,000 2,900 27
12,001 to 16,000 4,520 26
16,001 to 20,000 5,560 25
20,001 to 30,000 6,560 24
30,001 to 40,000 8,960 23
40,001 & larger 11,260 22
Zoning
District
MAX. PERMITTED
IMPERVIOUS
COVERAGE IN FRONT
YARD (%)
R-35 15
R-25 20
R-20 30
R-15 35
R-15A 35
R-12 40
R-10 45
R-7 40
R-5 30
R2-F 30
Area of lot:_____________sq.ft. Existing Allowed Proposed
Total impervious coverage = Sq.ft. Sq. ft. Sq.ft.
Front impervious coverage = % % %
900 King Street 129.68 1 13 PUD
773,908
7.46 ac 6.76 ac
3/21/19
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK, NY 10573
(914) 939-0668 FAX (914) 939-5801
BULK REGULATIONS IN RESIDENTIAL DISTRICTS
Address: Section: Block: ___ Lot: ______ ___
MAXIMUM GROSS FLOOR AREA
USE FORMULA: Maximum Gross Floor Area = 4,000 + [ (Lot Area – 21,780) x 0.11478421 ]:
a. Allowed = Sq. Feet
b. Existing = Sq. Feet
c. Proposed = Sq. Feet
HEIGHT/SETBACK RATIOS FOR RESIDENTIAL DISTRICTS
DEFINITION: A standard designed to regulate the height of a building in relation to the average grade of the corresponding portion of
the lot line from which it is set back. The ratio modifies the maximum permitted Height of Building by forming an inclined plane
beginning at the average grade along the portion of the lot line from which the setback is measured and rising toward the building at the
specified ratio above which no part of any building, other than minor architectural features such as chimneys, skylights and dormer
windows not covering more than 10% of the entire roof area, shall be permitted to extend. Height and Setback shall be calculated using
the formula; Height / Setback = X, where X is the required side or front yard ratio for the zoning district in which a property is located
as specified in Article VIII of Chapter 250. A complete elevation view for the proposed improvement must be included on the drawings.
FILL IN YOUR RATIOS:
I attest to the best of my knowledge and belief, the above information is correct.
_____________________________
Architect’s Signature (5)
ZONE EXISTING PROPOSED REQUIRED
R-35
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .44
SIDE: 1.20
R-25
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .48
SIDE: 1.30
R-20
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .60
SIDE: 1.60
R-15
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .60
SIDE: 1.60
R-15A
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .80
SIDE: 2.40
R-12
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .69
SIDE: 1.60
R-10
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .80
SIDE: 2.40
R-7
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: .96
SIDE: 3.00
R-5
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: 1.20
SIDE: 4.00
R-2F
FRONT:
SIDE:
FRONT:
SIDE:
FRONT: 1.20
SIDE: 4.00
900 King Street 129.68 1 13
PUD Requirements are different159,930
215,000
355,902
Not applicable to PUD
3/21/19
******************************************************************************************
Table R301.2(1) 2015 IRC
CLIMATIC & GEOGRAPHIC DESIGN CRITERIA
FOR RESIDENTIAL DISTRICTS IN RYE BROOK
(5a)
GROUND-
SNOW LOAD
WIND SPEED
(mph)
TOPOGRAPHIC
WIND EFFECTS
SPECIAL
WIND
REGION
WIND-
BOURNE
DEBRIS ZONE
SEISMIC DESIGN
CATAGORY WEATHERING
20 psf 115/120 NO NO NO C SEVERE
FROST LINE
DEPTH
TERMITE
PROTECTION
REQUIRED
WINTER DESIGN
TEMP.
ICE BARRIER
UNDERLAYMENT
REQUIRED
FLOOD
HAZARDS
AIR FREEZING
INDEX
MEAN ANNUAL
TEMP.
42” YES 15 YES FIRM MAP
36119C0279F 9/28/07
500 52.2
3/21/19
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK, NY 10573
(914) 939-0668 FAX (914) 939-5801
www.ryebrook.org
*******************************************************************************************************
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG
WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION
SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT.
STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as:
I, __________________________________, residing at, ____________________________________________
(Print name) (Address where you live)
being duly sworn, deposes and states that (s)he is the applicant above named, and further states that (s)he is the
legal owner of the property to which this Affidavit of Compliance pertains at;
___________________________________________________________________________, Rye Brook, NY.
(Job Address)
Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that
there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that
there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of
inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State,
County and Village Codes.
______________________________________________________________________
(Signature of Property Owner(s))
_________________________________ _____________________________________
(Print Name of Property Owner(s))
Sworn to before me this _______________
day of ___________________, 20_______
___________________________________
(Notary Public)
(6)
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: ________________________________________________________________________
Subject Property: __________________________________SBL: ______________Zone: _____
Please take notice that the subject; □ One or Two Family; □ Commercial,
□New Structure
□Addition to an Existing Structure
□Rehabilitation to an Existing Structure
to be constructed or performed at the subject property will utilize;
□Truss Type Construction (TT)
□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 §1265 for One & Two Family Dwellings.
_______________________ __________________________________
Date Design Professional
__________________________________ ___________________________________________________
Date Property Owner
__________________________________ __________________________________________________
Date Notary Public
(7)
TBD
TBD
TBD
3/21/19
This application must be properly completed in its entirety by a N.Y. State Registered
Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where
indicated. It must also include the notarized signature(s) of the legal owner(s) of the subject
property, and the applicant of record in the spaces provided. Any application not properly
completed in its entirety and/or not properly signed shall be deemed null and void, and will be
returned to the applicant. Please note that application fees are non-refundable.
**********************************************************************************************************
STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as:
_________________________________, being duly sworn, deposes and states that he/she is the applicant above named,
(print name of individual signing as the applicant)
and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
_________________________________________ for the legal owner and is duly authorized to make and file this
application.
(indicate architect, contractor, agent, attorney, etc.)
That all statements contained herein are true to the best of his/her knowledge and belief, and that any work performed, or
use conducted at the above captioned property will be in conformance with the details as set forth and contained in this
application and in any accompanying approved plans and specifications, as well as in accordance with the New York State
Uniform Fire Prevention & Building Code, the Code of the Village of Rye Brook and all other applicable laws, ordinances
and regulations. By signing this application, the property owner further declares that he/she has inspected the subject
property, and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or
groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property.
Sworn to before me this ______________ Sworn to before me this ______________
day of _________________, 20_____ day of _________________, 20_____
______________________________ ______________________________
Signature of Property Owner Signature of Applicant
______________________________ ______________________________
Print Name of Property Owner Print Name of Applicant
______________________________ ______________________________
Notary Public Notary Public
(8)
If you’re working on homes, schools or
day care centers built pre-1978, you
now must be EPA Lead-Safe Certified.
WHAT
The Lead-Based Paint Renovation, Repair and Painting
(RRP) rule is a federal regulatory program affecting
anyone who disturbs painted surfaces where lead may
be present.
• Submit an application to certify your firm for five years.
• A one-day class will certify your renovators for five years.
• Learn the required steps to contain the work area,
minimize dust and thoroughly clean up every day.
WHO
• Any contractor, including renovators, electricians, HVAC
specialists, plumbers, painters and maintenance staff,
who disrupts more than six square feet of lead paint in
pre-1978 homes, schools, day care centers and other
places where children spend time.
WHY
1. Avoid risk of government fines and civil liability:
- Without certification and by not following approved
practices, you and your company can face tens of
thousands of dollars in fines and put yourself and
your company at risk of potential lawsuits.
2. Protect your workers, yourself and your customers
from a health risk:
- Dust from renovation, repairs and painting can
contaminate an entire home and, if inhaled or
ingested, can cause irreversible damage to children
and adults.
3. Gain competitive advantage:
- Certification makes you stand out from others and
positions you as a professional contractor consumers
can trust. Using your company’s certification in your
marketing materials may help attract business.
- Consumers will look for the certification before hiring
contractors and may be more accepting of additional
costs and time associated with doing the job safely.
- Upon certification of your firm, your company will
be listed as a Lead-Safe Certified Contractor on
the EPA website, giving your firm the potential for
new customers.
WHERETo find an accredited trainer in your local area or get additional info, go to epa.gov/getleadsafe or call 800-424-LEAD.
WHEN
Now – Certification requirements begin April 22, 2010.
IF YOU’RE NOT
LEAD-SAFE CERTIFIED,DISTURBING JUST SIX SQUARE FEET
COULD COST YOUBIG TIME.
CERTIFIED F I R M
L E A D-SAFE
GET LEAD-SAFE CERTIFIED BY APRIL 22, 2010.
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET, RYE BROOK, NEW YORK 10573
(914) 939-0668 - FAX (914) 939-5801
www.ryebrook.org
APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE,
AND CERTIFICATION OF FINAL COSTS
TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THE FINAL INSPECTION
*****************************************************************************************************************************
Address: __________________________________________________________________________________________
Occupancy / Use: ______________ Parcel ID #:__________________________________________ Zone: ___________
Owner: ____________________________________________ Address: _______________________________________
P.E./R.A. or Contractor: _______________________________Address: _______________________________________
Person in responsible charge: ___________________________Address: _______________________________________
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a Certificate of
Occupancy / Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance with law:
STATE OF NEW YORK, COUNTY OF WESTCHESTER as:
______________________________being duly sworn, deposes and says that he/she resides at____________________________________
(Print Name of Applicant) (No. and Street)
in _________________________________, in the County of_____________________________________ in the State of _________, that (City/Town/ Village)
he/she has supervised the work at the location indicated above, and that the actual total cost of the work, including all site improvements, labor,
materials, scaffolding, fixed equipment, professional fees, and including the monetary value of any materials and labor which may have been
donated gratis was: $ __________________________________________________________________________________,
for the construction or alteration of: __________________________________________________________________________________
_______________________________________________________________________________________________________________
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancy / Compliance is sought, and that to the best of his/her knowledge and belief, the structure/work has been erected/completed in
accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized, and as
erected/completed complies with the laws governing building construction. Deponent further understands that it shall be unlawful for an owner
to use or permit the use of any building or premises or part thereof hereafter created, erected, changed, converted or enlarged, wholly or partly,
in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building Inspector as per
§250-10.A. of the Code of the Village of Rye Brook.
Sworn to before me this ______________ Sworn to before me this ____________
day of _________________, 20_____ day of _________________, 20_____
______________________________ ______________________________
Signature of Property Owner Signature of Applicant
______________________________ ______________________________
Print Name of Property Owner Print Name of Applicant
______________________________ ______________________________
Notary Public Notary Public
3/21/19
For office use only:
PERMIT # __________
ISSUED:____________
DATE:_____________
FEE: _____________PAID p