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HomeMy WebLinkAboutBP21-270PERMIT # /1(� ���/� 7© DATE: / o ai a i EXPO SECTION /�r 7 3 •_- BLOCK � LOT TYPE OF WORK JOB LOCATION owN T.lzoCOSH #__Q TCO # FEE DATE . INSPECTION RECORD DATE I P FOOTING L,,,sa FOUNDATION FRAMING RGH FRAMING INSULATION RGH PLUMBING GAS SPRINKLER ELECTRIC LOW -VOLT ALARM AS BUILT O FINAL _ C9��� 13 9 / OssS �� oc lt-%Pr��4' S/OVA ��urn6�n�sD���ia� �o OTHER APPROVALS ARB BOT PB ZBA OTHER VILLAGE OF RYE BROOK WESTCHESTER COLJti`TY, NEW YORK NO: 22-073 Certificate of (9ccupaucp Ehis is to certify thatlnehaaf� Fc7l'�va)-7)'k-e ka CZ J of, ��� ,�Yc�Q1C, �/� �� having duly filed an application on maV 20 requesting a Certificate of Occupancy for the premises known as, C;? S- Y 7feT , Rye Brook,NY, located in a f' '�7c111110 District and shown on the most current Tax Map as Section: / Block: I Lot: and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building Permit No. zQ I-0 70 , issued 20 02 1, 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: K"3/Too— Faxm/ lU, Construction: �P for the following purposes: Na YV I Ca./7 YeSk �i ors 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 been obta' a om ilding ector. 2022 Assistant Building Inspector,Village of Rye Brook: Date: . 19 4m a/T.f1ftieL ayy VILLAGE OF RYE BROOK MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A. Klein (914) 939-0668 Christopher J. Bradbury wwwaebrook.org TRUSTEES BUILDING& FIRE INSPECTOR Susan R Epstein Michael J. Izzo Stephanie J. Fischer David M. Heiser Salvatore W. Morlino CERTIFICATE OF COMPLIANCE May 17,2022 Mehmet Kukaj&Gjevahire Kukaj 2 Wyman Street Rye Brook,New York 10573 Re: 2 Wyman Street, Rye Brook,New York 10573 Parcel ID#: 141.43-1-11 This document certifies that the work done under Mechanical Permit #21-155 issued on 10/25/2021 for the installation of a new boiler and a new hot water heater has been satisfactorily completed. Sincerely, Steven E. Fews Assistant Building&Fire Inspector /to D v�7 )R For office use only. BUILDCIZ4d, ARTMENT PERMIT# -` 70 VILIAj�kOF RYE"*—OK ISSUED: - MAY 132022 938 KING STREIE'i.;ItYE BROOK, YORK 10573 DATE: FEE: PAID O VILLAGE OF RYE BROOK W . okliig BUILDING DEPARTMENT PPLICATION OR 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 ♦ursrsssrssr►rras»»rserssrrsr»rrrsrssssssrsrsrrrsrrrrrrrrssrrrrsrrrssrssrsssrsssssraasssasrrr»rsar►»rr»»»»•»r»»r»srsssrpsrs Address: N . Occupancy/Use:t9' Q rr1 Parcel ID#: Zone: PC?'p7 Owner: Address:��yyn C,11 5{r. Q I e 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: 1STQQATE OF NEW tY�ORK,COUNTY OF WESTCHESTER as: I�l P�t v►� P k Ukc4i being duly sworn,deposes and says that he/she resides at \YJ u 1-v�q . (Print Name of Applicant) 4No.and Street) in 2s.., Q_ T)-� !c2 p�'_ ,in the County of �C-4 e me^K 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:$ 5,0 O 0 for the construction or alteration of_En j+D )Cl'a-) r-2 T�-p { q J lrOe 14 S 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 k 3 Sworn to before me this day of �Apl,A , 20 J� day of 1 Signa re of Property Own Signa� plicant I LA e.� j4 Lr Upkm ' Print Name of Property Owner Print ame of Appl' n Nota lblic 1' KIRSYS LANGLEY rNotary LANGLEY Notary Public-State of New York State of New YorkNO.01LAateof 7 LA632287 88/12/2021 Qualified in Westchester County estchester CountyMy Commission Expires Apr 13, 2023 xpires Apr 1 3. 2023 �E BRC��, • 1932 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.Uebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - --- - - - - - - - - - - - ADDRESS ' �t )\ cnan <�A DATE' r 16 -LC 2-7 PERMIT# 1 (Y , `-' ISSUED: t J l �ECT: BLOCK: LOT: y7l� LOCATION: 1 J�� OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION ^ /mil REQUIRED ❑ FOOTINGl ❑ 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 "FINAL ❑ OTHERav C{� QyE BRC�� O� tim 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR P.4ASSISTANT 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: �\ -=> 1 DATE: PERMIT# - `-� ISSUED: Z1SECT:._'q I `1 2BLOCK: i LOT: OCCUPANC LOCATION: �. YI ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION SITE INSPECTION / (� 1 REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS !V ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER N N M = N N Gtl 0 0 w v M w a Cn -- w a C x Ca i en � 00 _ W C v a w o �- � w � 10 M W $ � Q O CN _ �. ✓ w � p U :.i z A� V z x _ '"� w o0 a a ---, U O w cz Z Q H a � � x N o � N n w it U er W i f z F � v� W z �s 2 ¢ w Q g 0-4 • v w z a x y A ° > a V, H O Ca i S Fi EC�EWE BUIL DEPARTMENT FEB - 4 2022 VIL E OF RYE OK VILLAGE OF RYE BROOK 038 KIN ET RYE B ,NY 10573 BUILDING DEPARTMENT '. 0 .or ELECTRICAL PERMIT APPLICATION Westchester County Master ElectriciansLicense Required FOR OFFICE USE ONLY BP#: �f — a /-7 U LP#: Approval Date: FEB :— 7 ,2022 Permit Fee: $ / Approval Signature: Other: ?1 yeC�' — Disapproved: _ (fees are non-refundable) Application dated, 01 is'tereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of 9 a Permit to install and/or rethove 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 Cold/es. 1.Address: la nk Q,(� _- 12 6. 130M h, SBL: I7I� 7 3 "" `/ Zone: 2.Property Owner: G Address: Phone#: 310. 30. 3 hl,� Cell#: email: 3.Master Electrician:Yt eV E N 6 I N Address: Lic.#16G) Phone#: ig-341.O N Cell#: email: P , Company Name: RA&VAVN1 (R&, W _Address: ()ZDN(i P9 [k 1 4.Proposed Elec 'cal Work/Fixture C unt• __ STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: PHAMtf+ Kuk A(< ,being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual sibming as the applicant) state that(s)he is the legal owner of the prop.:rty 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.) 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 accompanying approved plars 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 tg before me this o A Sworn to before me this 44�_' day f S n ,20422L— day of e ,20 _ / Signalure7of Pro erty Owner Signature f Applicant _ ,,`,�grarn,rnp,rrr� L✓ Print o P erty Owner ;..`` �JN ME 4f Print Name of Applicant OQ.'••STATE. Notary Public ;�OF NEW YORK votary Public 3;NOTARY PUBLIC' N Qualified in co' New New York County : Marva M. Dudley .01MEti402675.'��^; Notary Public, State of New York s ' S° Reg. No. 01 DU6363384 SOON EXP\R%00��` Qualified in Queens County , „ ,,'�Q""rrr,nrr"' � Commission Expires August 21, M1, �- Westchetter Rockland Electrical Inspection Services, Inc. Phone: 914-347-3595 DO NOTWRITE HERE-FOR OFFICE USE ONLY P.O. BOX 20$ 44 {/, FaxA4;347-3596 Carmel, NY 10512 BUILDING PERMIT NO. TEMP# CITY OR VILLAGE / ZJP CODE TOWNSHIP COUNTY � S STREET AND NO.OR POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS P EMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S NAME BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS HOME TELEPHONE NUMBER /n CURRENT SUPPLIED BY FROM THEIR OFFICE Vy TELEPHONE NUMBER L : LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDEWALL SWITCH INCADE FLUORE NO. H.P EACH NO. WATTS EACH INSPECTION OUTSIDE BASEMENT I"FL. Lj 2-FL. - L. B ILDING DEPAR MENT REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: /.tc <Ar/r 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 AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN APPLICATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY WREIS, INC.IS NOT LISTING,LABELING,UNDERWRITING OR CERTIFYING ANY EQUIPMENT, MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT,OWNER,OR AUTHORIZED AGENT AGREES TO ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION, SIZE OF SERVICE FEEDERS CHARACTER OF WORK NEW LJ ADDITIONAL O EXPOSED❑ CONCEALED p MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD[] UNDERGROUND❑ 1 I I - -t� AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED, NAME OF COMPANY / /< ` DATE OF APP CATp L:�:�lCANT ,� ' STREET ADDRESS TELEPHONE NO. CITY OR POST OFFICE ZIP CODE 41 LICENSE NO.WHEN APPLICABLE AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA STATE OF tJLl COUNTY OF c (insert name), being duly sworn, deposes and says 1. I am the applicant for a Building Permit/Certificate of Occupancy/Demolition Permit Electrical Permit/ Plumbing Permit/Fence & Wall Permit Mechanical Permit/Pod Permit(circle all that apply) 2. I am the legal owner of property located at -- �4 7-�Z/ Rye Brook,New York (insert street address) OR I am th (Architect/Contractor/Engineer/Attorney) (circle one) for the legal owner of property located at �1 �4^� f � , Rye Brook, New York and I am duly authorized by property owner 1,�jZ 6,vj to make and file the accompanying application. 3. The following is a description of(1) the work to be performed under the permit for which I am applying; and (2) how the work arose as a direct result of Hurricane Ida: 4. The work described herein arose as a direct result of Hurricane Ida and does not include Work which was not caused by Hurricane Ida. Sworn to before me this Day of , 20 Notary Public "!it?i i'GPHcR J. BRADBURY D E C E M ED Nuza;ry Public,State o`New York No.01 F R61599135 FEB -4 2022 Qua'ifie„in Westchester county C^...... :,n Pxo;res January 29,20 Zs VILLAGE OF RYE BROOK BUILDING DEPARTMENT WESTCNESTER ROCKUNO ELECTRICAL INSPECTION INE15SERVICES,INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Aardvark Electric Mehmet&Gjevahire Kukaj 94-24 88th Street NY, Ozone Park 11416 Located at:2 Wyman St Rye Brook, NY 10573 Certificate Number: 1034265 Section: 141.43 Block: 1 Lot: 11 BDC: Permit#:EP:22-021-BP:21-270 A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 2 Wyman St Rye Brook,NY 10573 Basement 1st Floor 2nd Floor 3rd Floor Garage Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 05/13/22 Name Type Quantity Fixture-Luminaire Incandescent ------- 12 Receptacle Convenience ------- 20 Switch Single Pole ------- 6 Smoke Detector ------- 2 Special Receptacle Air Conditioner ------- 2 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. �` This certificate is valid for work performed before date of inspection only. ` ���i�i��1��1�i�I�I�Ifi������G�1���i����C��l��i�l�l�i�p�������•fig L in N N (W►'� aC O v ig �. m w•3 2 ;E u w � J 0. 5 O ^gy p Od �^ i lil � �_ g = x ¢ �• r � C r O �I M � �, •-� ,o c 3 .. E � CC F• Cps r 0.0cr W .- .• C ei o ao > • 9+�1 33 _ .. � Q � p o � ;� o ;� mm' •� C = Q oo a _ _ t 0-0 pa to s M w U = gi � •yE a� WZ Qrl = Z u ae o � BoCL _ co O Q F m Z Flu .. n.'R't v, a. Iz- EE IQ � aa � � �i :: ED BUILDING DEPARTMENT D V VILLAGE OF RYE BROOK OCT 24 2021 938 KING STREET RYE BROOK,NY 10573 (914) -0668 VILLAGE OF RYE BROOK www.t'yehrook.org BUILDING DEPARTMENT ERMIT APPLICATION D FOR OFFICE USE ONLY BI' : / p1-7 O Approval Date: UCj Permit Fee: $ NO MED Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, Z l 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. 1.Address: VV T SBL:.Z.W, 4,3 —/—// Zone: F-ii3-z�� 2.Proposed Work: L l` U lC- / c 3.Property Owner: Address:� � �� Phone#: rm Cell#: email: 4.Master Plumber: Address: L, Lic.#:_ �Phone#: 3 6 4/Cell#: — 1( email: pp O�� °,AI iy LV �A:f Z)�, ,_CQM Company Name: 0\A �� M (� � ScQLQnOK Address: -( CLIf— U, " �( m r c f 0 INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement Ist Floor 2nd Floor 3'd Floor 4d'Floor 51 Floor Exterior 5.* List Other Equ'pmen�t/P`rovide Details: 1`' V w VV �/1fy (Notarized Signatures Required Next 2 Pages) -I- 8/IM021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: J t kr- f 01 ,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. (it:2cathilect,%c�Lctor,agent,attorney,etc.) That alnts 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 1 51-h Sworn to before e this ) day of ,20 9- 11_ day of CC ,20� " AR�4 N Signature of Property eyner Signatu pplicant U-P�A Vo P+ \-L N� A 60S 0, Print Name of Property Owner Fkint Name of Applicant 0 LA Kblic- State LEY of Notary Public-State of New York N ry Pu 1 NO.01LA6322877 Notary P Qualified in Westchester County RI MELILLO My Commission Expires Apr 13,2023 Notary Public,State of New York No. 01 ME6160063 Qualified in Westchester County Commission Expires January 29.20 a 3 This application must be properly completed in its entirety and must include 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- 8/12no21 BUIID MENT C f 1 VILOF R OOK --� 938 KINGET RYE BR ,NY 10573 OCT 19 2021 �r Ly VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE U 16 • 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: `, residing at, 2 W S T rS l�p CC (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; f t,: Pj P(�' /� , 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. �4 if �( AM-A (Signature of Property O n r(s1) (Print Name of Property Owner(s)l Sworn to before me this day of �% '�"� ,20 a IENotary ANGLEY tate of New York6322877 tchester County ary Public 1 pires Apr 13,2023 -3- 8/12/2021 AFFIDAVI I IN SIT110RT OF FFF' \k':\I\'I-.R RITA ITD TO I WRRWANI. II) \ STATE, 01: ("(WNI ), 01- vje-,5+CJqe --.5tef (insert name). being dul\ s%%orn. deposes and �a, I. I am the applicant fOr a f;uilding Permit Certificate ►►f )ccupanc\ Demolition Permit Electrical Permit I'lunthing nit hence K Wall Permit Mechanical Permit Pod Permit (circle all that appl\ 1 2. 1 am the legal owner of propert\ located at R\e Brook. New York (insert street address) OR I am the (Architect ('ontractor Fngincer .\ttorne\ ) (circle one) for the legal o\%ner of propert\ located at -..G y y}1 Ct j S-�( e tt Rye Brook. New York and I am duly authorized h\ propert\ owner I�A e ut to make and the the accompan\ing application. 3. The lollo%\ing is a description of( I ) the �%ork to be performed under the permit for which I am appl\ing; and (2) ho%% the %%ork arose as a direct result off lurricane Ida: P-�--�tACC -Rol\ cne- ( Hc w ) "0 4. The Mork described herein arose as a direct result of I lurricane Ida and does not include Work ,%hich was not caused h\ I lurricane Ida. tiworn to before me this 0 Public _. 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'SOP i3 Left l" F milt , Right FAWN FLOORING Off tssl�4.�"[9(�'� C� yW6 FM USE SLY TN AUTONgA',T C � 0AhjpFR pFV4Cf AS FOLLOWS. ,VEt4z p_W PART MODEL NUMBER 21 S► c1�a^ GVD-4 1 02284-01 GVD-5 1 C2284.02 5)d 5ed1 on GV D-6 1022B4-03 7I$5ed*n GVD-7 1022$4-04 9 �OcNon G"40-B i 02-4B4-O5 f ritko°+tMt 1NSZ k "AT1Dt4 *4S7 RUCT ICONS � 10004 DES �� Building Permit Check List&Zotung_Analysis!1 1r Address yo A SBL. Zone- 2_1_-�P__Use: Z2 Const.Type: \9Tr Other. Submittal Date: b I Revisions Submittal Dates: Applicant: 1 c y k A Nature of Work rL IL L c,4 r-+� �Q �►i-F�R��ti _-�'��`���� Reviews:ZBA: O C T 2 0 202 1 PB: BOT: Other. NEED OK ( ) ( FEES:Filing. BP: C/O: Legalization: ( ) (-APP: Dated- —"Notarized. ✓SBL- -truss I.D. Cross Connection: ✓H.O.A.: ( ) ( ) Scenic Roads: Steep Slopes: Wetlands: Stone Water Review: Street Opening. ( ) ( ) ENVIRO:Long. Short: Fees: N/A: ( ) ( ) SITE PLAN:Topo: Site Protection: S/W Mgmr.: Tree Plan: Other. ( ) ( ) SURVEY:Dated: Current Archival:- Sealed. Unacceptable: ( ) ( ) PLANS:Date Stamped: Sealed Copies: Electronic Other. ( ) ( ) License: Workers Comp: Liability Comp.Waiver. Other. CODE 753#: Dated: N/A: (01 ( ) HIGH-VOLTAGE ELECTRICAL:Plans: Permit N/A: Other. ( ) ( ) LOW-VOLTAGE ELECTRICAL:Plans: Permit: N/A Other. ( ) ( ) FIRE ALARM/SMOKE DETECTORS:Plans: Permit: H.W.I.C.:_Battery-_Other. ( ) ( ) PLUMBING Plans: Permit Nat.Gas: LP Gas: N/A/: Other. ( ) ( ) FIRE SUPPRESSION:Plans: Perot 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. ( )AM mtg.date: approval• notes: ( )ZBA rnrg.date: approval• notes: ( )PB mtg.date: approval:- notes: REQUIRED EXISTING PROPOSED NOTES APPROVED ^-•-- nor 9 f1 CL= FrmW Front: Front: Sides: W. Main C v Accs.Cov Ft.HS : S .HS • Tot,Imp EL Imp: P�rk�Q Hcj&/Stories: notes: