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Home My WebLink AboutBP21-168PERMIT # �P�I - � DATE: Ia � � gyp; SECTION �i�S�r �'�% BLOCK LOT TYPE OF WORK /r%per `jp� e,.�n� 10B LOCATION l�� LC.%i.� inc� %lnn .M� OWNER_ i! �QMil1 �L/�� CONTRACTOR EST. COST �/co #�; TCO # FEE DATE INSPECTION RECORD DATE FOOTING FOUNDATION FRAMING RGH FRAMING INSULATION PLUMBING � �— RGH PLUMBING GAS SPRINKLER INSP ELECTRIC Ll0 _�{.�f1_��,' LOW -VOLT j� _ _ ALARM C] - AS BUILT [� _ FINAL r7 (�93-- 59�y OTHER APPROVALS ARB BOT PB i- ZBA _ OTHER s. VILLAGW,OF RYE BROOK WESTCHES COUNTY, NEW YORK NO: 22-099 Certificate of Occupancy This is to certify that &n)CLM f f7 kubln f kolci7ebk Ru-b')r7 of, / yc ,�VCx a lam, / V� 7 having duly filed an application on JUC / :7, 20_,?Q requesting a Certificate of Occupancy for the premises known as, lU , Rye Brook,NY, located in a �2-15 Zonin- District and shown on the most current Tax Map as Section: . �31 Block: Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. c2� , issued 7 20 - , such authority and permission is hereby granted to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following New York State Classifications, Use: e-.3 / ok7 e" rQt'17/.J� Construction: -.l�-7 U , for the following purposes: )n4-eyl-0y, Y—) ) lk Ic n P-e nQVoh Q rl Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the following: This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises, building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition. No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement, whether by extending on any side or by increasing in height shall be made,nor shall the building be moved from one location to another until a permit to accomplish such change has be btai d from the Building Inspector. Building Inspector,Village of Rye Brook: Date: JUN 3 0 2022 Win\ For office u e nl : BUILDlr' k—kTMENT PERMIT U N 1 2�22 VILLAGE OF RYE BROOK ISSUED: '7-/,4-3/ 938 KING STREET,RYE BROOK,NEW YORK 10573 DATE: VILLAGE OF RYE BROOK (914)939-0668 FEE: PAID BUILDING DEPARTMENT www.rylbrook.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 ►■►tit■flit■ttttttiiit#it#t######i##tt►itt►flit\►ttt►itti#tt########ii►►■R►►►ittiitt►tttt#t#t##tt■•##t####►#►ii►►itii►►#ttttt Address: r S w 1✓1 Yt Occupancy/Use: Parcel ID#: 13 5 , 4 — l ° Zone: Owner: 3{,yj 1 GI Vr ' r1 d- 12- (!C IAA 11e- Z'A kI n Address: 1%5a. -e P.E./R.A.or Contractor: Address: Person in responsible charge: vti r, 2u. b( o 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: �STnATE OF NEW YORK,COUNTY OF WESTCHESTER as: l IL ti I*Ck vN I n 2`*'' "ki being duly swom,deposes and says that he/she resides at J (Print Name of Applicant) (No.an treet) in yC 00 9, in the County of J L h )a'C ►� 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:$ � U I 'Z 1 7 for the construction or alteration of 1� T-e✓, C ✓ t/v +'C i 2 1,,o t/ 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 y Sworn to before me this day of µ ,20 day of , 20 i�ature of Property Owner Signature of Applicant !/ I/1 \ Cl l - I 'n 7 t/l .4 1 Yl Name ot Property Owner Print Name of Applicant Notary Pub c SHARI MELILLO Notary Public Notary Public,State of New York No.01ME6160063 8/12/2021 Qualified in Westchester County Commission Expires January 29,2 QyE BRC��. BUILDING DEPARTMENT ❑BUILDING INSPECTOR ,, ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET . RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : ` `�- DATE: 4 PERMIT# l ` ISSUED: \SECT: (-;�N ?-LOCK: Lot4(0 LOCATION: ( `� �J1 �� Y` OCCUPANCY: C'b off" ❑ VIOLATION NOTED THE WORK IS.. �ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION \ REQUIRED ❑ FOOTING C�J ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION INAL OTHER • BUIL yE Eu� MENT D v 1 VIL E`OF RYE OK 938 KIN ET RYE B ,NY 10573 JUL 2 2 2021 (914)9 939-5801 VILLAGE OF RYE BROOK W 4V :.orgy BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required c� FOR OFFICE USE ONLY BP#: /—j 4p ? EP#: 'D/ —/ b JUL 262 ,TO _P6 Approval Date: � / Permit Fee: $ I_J Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, 07 37o1 4/ is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install an&&remo a electrical equipment, wiring, fixtures ,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal,State,County and Local Codes. u 1.Address: 5 V V (A 0061 ( SBL: /3• 3y"'�' 7� Zone: 2.Property Owner: e A)^ a't lt- ku t o Address: r Phone#: -5 q 4-Lt � Cell#: email: �b n.G�e.AA QC/ ,; 3.Master Electrician:K{,V j rl 1 t cl I t c' Address: Lic.#: 1-7 5 y Phone#: q I'-/-3 ga -q'131 Cell#: email: Q rrt m{✓GI{y �e��-� M�h Lam'''' Company Name: A M ryl4./ t l ec.+/( G Address: r Ino7 y� 0550 4.Proposed Electrical Work/Fixture Count: T{ c.-c p; fps y (�h{) 3 5 w fic_fr►.e S STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name ofindn idual signing as the applicant) state 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. lindicatc mchitcet,contractor,agent,attorney,etc.) The undersigned further states 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 accompdnying 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. Sworn ko before me this 0fl- i Sworn to b fore me this day of J \C 20� day of (1 � 20� e:ttur_e of Property Owner ature of Applicant e�, vt., 2 h S Print N e of Property Owner Print Nam a plicant Notary c Notary bl' STEVEN R. HOFFMAN EVEN R. HOFFMAN Rotary f'ub'ic, Sla+e of New York Notary Public, State of New York r o. 01)i! 004832 No. 02HO5004832 sou County Qualified in Nassau County 23, 20 vti Commission Expires Nov. 23. 20 3/21/19 INSPECTIONSTATEWIDE IntegrityService With 1:1 Main Street, Fishkill, NY 12524 1 email:• • SWIS JOBAPPLICATION :, 1 • • 1•21 SWISNY.corn I SWISTraining.com Office Use Elect. Permit# Date Bldg Permit# Utility ID# Final Certificate# City/Village Zip Township County - _ Address Cross Street Section Block Lot Owner Name/Address(If different than above) Contact Number ❑Basement ❑1st FI. ❑2nd FI. ❑3rd FI. ❑More Than 3 A. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑ New ❑Reconnect ❑Overhead ❑Change ❑visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information S � 5 4 ` JUL 2 2 2021 -ID) VILLAGE OF RYE BROOK tv BUILDING DEPARTMENT This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name Date Signature Address City/State Zip Code License# Phone# State Wide Inspection Services CAC) 1080 Main Street ishkill, NY 12524 TO845 2 Phone 914-219-119-1062 Fax STATE WIDE INSPECTION SERVICES Email: officePswisny.com Website: www.swisny.com Service With /ntegrlty BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Ammer Electric LLC Benjamin& Rochelle Rubin Kevin McLeod 65 Winding Wood Road 3302 Gunther Avenue Rye Brook, NY 10573 Bronx, NY 10469 Located at: 65 Winding Wood Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 21-185 135.34 40 Certificate Number: 2021-3869 Building Permit Number: BP 21-168 A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at:65 Winding Wood Road, Rye Brook, NY 10573 The As Built First Floor Kitchen was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation,as set forth below,was found to be in compliance on the 6th day of August 2021. Name Quantity Rating Circuit Type GFCI 05 Switches 03 Dishwasher 01 Receptacles 05 Luminaires 04 Switches 03 A Visual Inspection of existing conditions was performed on August 6`h, 2021 of the As Built First Floor Kitchen and conforms to NFPA 70-2017 NEC. No Defects Were Noted. JJ� Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only. t s' ■ s 00 N N O O N Ln 1 N \ ti W r N \ LnN Ln ' � Z z " O w c �--� a p Zo W z a zLn 0 Fil p 0 x Q tn r, z W 4" oo L+ C z a N tA w U V 00 a A Z ai U d O 00 q a o od c o 1, O a zz O s O D 1 z Q N c7 H w as z g Z o a w N ° s y3 V P. a 6 � " x 4 x � _ IE EYED BUI q EPARTMENT VIL , ' E OF RYE i OK FMAY12022 938 KINq ET RYE B ,NY 10573 RH (914)93 ' 939-5801 VILLAGE OF RYE BROOK or BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: �— (r7 PP - jApproval Date: MAY 4 2022 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, 04/02/22 is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below. The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. LAddress: 65 WINDING WOOD ROAD SBL:/35, 3 J/1 910 Zone: 2.Proposed Work: KITCHEN RENOVATION. 3.Property Owner: BENJAMIN RUBIN Address: 65 WINDING WOOD ROAD Phone#: Cell #: 212-693-5944 email: 4.Master Plumber: Salvatore W Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Lic.#: 725 Phone#: Cell#: 914-260-1592 email: salvatoreserious@gmaii.com Company Name: Westchester Plumbing And Heating Address: 1 Bonwit Road Rye Brook NY 10573 INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fist; Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor 1 1 2 2nd Floor 31 Floor 4 Floor 5'h Floor Exterior 5.* List Other Equipment/Provide Details: . DISCONNECT AND RECONNECT SINK,DISWASHER AND RANGE. (Notarized Signatures Required Next 2 Pages) -1- 3/21/19 BUILD MENTRRVIL E OF RY OK 022 938 KING ET RYE B NY 10573 VILLAGE OF RYE BROOK (914)9 , 9 39-5801 BUILDING DEPARTMENT 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: X, BENJAMIN RUBIN , residing at, 65 WINDING WOOD ROAD (Print name) (Address where you lice) 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; 65 WINDING WOOD ROAD , Rye Brook, NY. (.lob 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. �i X (Signaler ruperiy Owners) BENJAMIN RUBIN (Print Name of Properly W ner(s)) Sworn to before me this day of 1(, , 200L Not i York Q ,y (Notary Publics Comm:_ 20 7 CT_ i __ I Nota, York Q_arAl1: t,;3unty COMM",Siun L-npues kc:v. 23, 20 -3- 3/21/19 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Salvatore W Morlino ,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 Contractor 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. Sworn to before me this e Sworn to before me this 04 k' day of IL 204A, day of APRIL ,2022 x S' a re Property Owner "Signature o Applicant BENJAMIN RUBIN Salvatore W Morlino Print Name of Property Owner Print Name of Applicant NOtaryP bI1C, r�vrni �-i^•rrann, STF Notary Public �' York ANNETTE MOFIDNO Notary h' Nowy Pal tic,State of flew York pu " `y No.01 M0601 1281 Commis _. . 20 -- Qtts!+P?1ie}d in W9eStCh@atsf County , a >1 on Expl,os August, g,20.�.�- This application must be properly completed in its entirety and must incrude the notarized signature(s) of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 3/21/19 • 9800 Fredericksburg Road D V San Antonio, Texas 78288 001 % usAA® JUL - 9 2021 VILLAGE OF RYE BROOK BUILDING DEPARTMENT BENJAMIN A RUBIN AND ROCHELLE RUBIN July 9, 2021 65 WINDINGWOOD RD S RYE BROOK, NY 10573 Reference: Existing USAA Homeowners Insurance Policy Summary We're writing to provide the following summary of the USAA homeowners policy: Effective date of policy: February 11, 2021 12:01 a.m. local time Policy expiration date: February 11, 2022 12:01 a.m. local time Policy location: 65 WINDINGWOOD RD S, RYE BROOK, NY 10573 Policy number: GAR 035852441 92A Named Insured: BENJAMIN A RUBIN AND ROCHELLE RUBIN Description of coverage(s) Dwelling coverage: $555 000 Home Protector: Included Personal belongings: $277,500 Personal liability: $1,000,000 Medical payments: $5,000 Deductible(s) All other perils: $2,000 Hurricane: 2.00% ($11,100) Revised Annual Premium: $1,852.97 Mortgage clause: JPMORGAN CHASE BANK, N.A., ISAOA/ATIMA PO BOX 4465 SPRINGFIELD, OH 45501-4465 Loan number: 1910466024 Your Home Protector coverage, if included, provides you an additional 25% of dwelling coverage. Policy terms, conditions and exclusions apply. Notification to Additional Interest Upon Cancellation If this policy is canceled or not renewed, the mortgagee/lender will be properly notified at least 10 days before the date cancellation or nonrenewal takes effect. 035852441 - DM-04664 131780-0521 Affidavit of Exemption to Show Specific Proof of Workers' Compensation Insurance Coverage for a 1, 2, 3 or 4 Family, Owner-occupied Residence **Thu form cannot be used to waive the workers'compensation rights or obligations of any party.** Under penalty of perjury, I certify that I am the owner of the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums) listed on the building permit that I am applying for, specific proof of workers' compensation insurance coverage for such residen appropriate box): ❑ I am performing all the work for which the building permit was issued. F - 9 2021 VILLAGE OF RYE BROOK ❑ I am not hiring,paying or compensating in anyway,the individual(s)that' fIM WR for which the building permit was issued or helping me perform such work. .� I have a homeowners insurance policy that is currently in effect and covers the property listed on the attached building permit AND am hiring or paying individuals a total of less than 40 hours per week (aggregate hours for all paid individuals on the jobsite) for which the building permit was issued. I also agree to either: ♦ acquire appropriate workers' compensation coverage and provide appropriate proof of that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if I need to hire or pay individuals a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated on the building permit,or if appropriate,file a CE- 200 exemption form; OR ♦ have the general contractor, performing the work on the 1, 2, 3 or 4 family, owner-occupied residence (including condominiums)listed on the building permit that I am applying for,provide appropriate proof of workers'compensation coverage or proof of exemption from that coverage on forms approved by the Chair of the NYS Workers' Compensation Board to the government entity issuing the building permit if the project takes a total of 40 hours or more per week(aggregate hours for all paid individuals on the jobsite)for work indicated n the building permit. (Signature of Homeowner) (Date Signed) )�a IA,1 C1 vi'l /I-) zt i 6, -, Home Telephone Number (Homeowner's Name Printed) Sworn to before me this _A day of Property Address that requires the building permit: CS ' (County ClerI��p�r RI NMEbrEotar o Public) ��e (� �� Al l75 7� StiA Notary Public,State of New York No.01 ME6160063 Cualifled in Westchester County Commission Exnires.Januani 29 2n a3 Once notarized,this BP-1 form serves as an exemption for both workers'compensation and disability benefits insurance coverage. BP-1 (12/08) NY-WCB Building Permit Check List&Zoning Analysis Andress: S W i 00-,- SBL• Zone:i2-1-5— Use: z Const.Type : - Other. Submittal Date: _ Z f Revisions Submittal Dates: Applicant: �1 Nature of Work: I► 't-p4 L k o 12+-t-'c2vx-t,*?o t` Reviews:ZBA: JUL 1 2 2021 PB: BOT: Other. NE OK ( ( ) FEES:Filing: 7S-�: � BP; l SS- � C/O: Legalization: ( ) (-"P: Dated ✓ Notarized ✓SBL- -'--Tnus I.D. Cross Connection H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Storm Water Review: Street Opening: ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection S/W Mgmt.: Tree Plan: Other. ( ) ( ) SURVEY:Dated Current: Archival• Sealed Unacceptable: ( ) ( ) PLANS:Date Stamped: Sealed Copies: Electronic Other. ( ) (-+'J �eme: Workers Comp: Liability: -Comp.Waiver.t./' Other. ( ) ( ) CODE 753#: Dated N/A: (� ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permi: N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL-Plans: Permit: N/A: Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: I-W.I.C.:_Batter)r_Other. PLUMBING Plans: Permit: Nat. Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Permit: N/A: Other. ( ) ( ) H.V.A.C.: Plans: Permit: N/A Other. ( ) ( ) FUEL TANK Plans: Permit: Fuel Type: Other. O O 2020 NY State ECCC: N/A: Other. ( ) ( ) Final Survey Final Topo: RA/PE Sign-off Letter. As-Built Plans: Other. ( ) ( ) BP DENIAL LETTER: C/O DENIAL LETTER. Other. ( ) ( ) Other. ( )ARB mtg.date: approval:- notes: ( )ZBA mtg. date: approval:- notes: ( )PB mtg.date: approval;- notes: REQUIRED EXLS'ITNG PROPOSED NOTES Art Date. _JUL 1 2 2021 Circle: FrooW From- Front. Sides: lam: Main Cov Accs.Cov Ft.H Sb: S .HS : SQFA: Tot.fig: Ft Imv: PkinQ Hcight/Stories: notes: