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HomeMy WebLinkAboutRP21-062 N �O ' p O �••� N N a •cd v I U o .n � � ,M., � ° E `� �,^` •� � GAG E-� • o A [� rA c�•JG ° o 3 TThh � Q00 Z W z C7" W � H ►� Z E� � `U d' C Z � a= � � ar W aQJZ � ¢ F � G .. F da ° °«�' w ,04 W FBI Q� � � a � O �../ W � v C/a '•r•�' ° �/1 �] L d O ai W O a� ' 0b � a Er 0 C/2 W C p `n � n 'o � 0 41 0-4 Ln wq c G "o n 0" w G4 H O A W Z �: z a 00 J G V DECENE Bu LD TMENT OCT 2 2 2021 DD VII _E OF Rom, OK 938 KING i1T3R, NY 10573 -� VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE ONLY: ` Approval Dat� T 2 5 20 rmit# r� Application# Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: use# Chairman: PB Approval Date: Case# Secretary: ZBA Approval Date: Case# Other: Application Fee: Permit Fees: ROOF PERMIT APPLICATION Application dated: Ocir W is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit to Re-Roof an Existing Building,as per detailed statement described below. 1. Job Address: 3 S T2�:k hi SBL: Zone: F,—/.5 Property Owner: Jz C'3 F_1_' W . Cj EV ILC G S Address: S A JA Phone#: Cell#: R 17 -7,V 7-(_cj' 7L email: F_(Sep C.C'- HQ TP147 L.C007 2. Applicant: P_G%C AJT W (SEYE¢Gsc S Address: 3'S l.jrv11'VGW0Vb "Zb IV Phone#: Cell#: 9)7 7`Y 2 �976 email: 'RG UDRGWS Q-Ko T)nN i-eon 3. Roofing Contractor: `R g� 1 �.1-DIL4nC,►v Address: A34Ny'_R's P.) Phone#: Cell#: 9/V-'g 72 - 752�) email: 1zA M I P Z e- MM L.C or► 4. Job Description,list allMethods&Materials: - 7 ^1� VM I vJ r"1 T�1 r N G C A/h A' 0 N 5. Estimated Cost of Job:$ :,�L% S01D (NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis,) 6. If comer property,indicate street frontage: 7. Construction Type: NYS Construction Class: 8. Number of stories: ()N E Height: 9. is garage being re-roofed:No: ( )•Yes:(Attached No: O•Yes:(Number of Cars: 10. Is roof peaked,hip,mansard,flat,etc: 11. Estimated date of completion: N'01C-grti. -t- 8/12/2021 Please note that this application must include the notarized signature(s) of the legal owner(s) of the above-mentioned property, in the space provided below. Any application not bearing the legal property owner's notarized signature(s) shall be deemed null and void, and will be returned to the applicant. STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: O nG TR 4 C ,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 Q W N V It for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,anomey,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_ �, Swom to befo e me this day of Dc � .209 day of © L- , 20� '--)D�- W , 0. Signature of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant Notary Public Notary Public Rrk w C.Lana# N OI A6=42�Y ryHbh�d G C Eu s Feb.29,20.�� No 81 *Y. r.ORMt19ek Emkis Feb.Z%%Ny �--L• -2- 811212021