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Home My WebLink AboutPP21-165 a Ln to N N N a 1 = un F = _ May � � j�► � Q � � � a 00 O, a� 00 [� Z W W O O �1 = z = o � � Q a w o f r z d � { N 1 O x I/ PLO o � a U v w U 66 a cn p w p � opo FMCE ��I BUILDING D YARTMENT OCT 2 0 2021 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK (9]4) -0604 BUILDING DEPARTMENT www.i R- gook.om, — PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY 131' #: i'1'#: c5 Approval Date: OCT 2 ZQ11 Permit Fee: S / 75 / 'v Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, 1 0/2 012 02 1 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: 201 Country Ridge Drive SBL: / C)9, 8 c-) —/— a() Zone:isD—/S 2.Proposed Work: Disconnect Pool Heater at source and install locking gas valve. a_o1 3.Property Owner: Sue Zeitlin Address: -2*@ Country Ridge Drive Phone#: Cell#: 1-917-74j 0640 email: 4.Master Plumber: Sal Morlino Address: 1 Bonwit Road Rye Brook NY 10573 Lic.#: 725 Phone#: 914-260-1592 Cell#: email: salvatoreserious@gmail.com Company Name: Westchester Plumbing & 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 Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor Yd Floor 41 Floor 51 Floor Exterior 1 1 5.*List Other Equipment/Provide Details: Disconnect Pool Heater at source and install locking gas valve. (Notarized Signatures Required Next 2 Pages) -I- 8/12/2021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Sal 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 20 Sworn to before me this 20 day of October 20 21 day of October ,20 21 ignature of PrQgqrty Owner Signature of Applicant Sue Zeitlin Sal Molrino Print Name of Property Owner Print Name of Applicant Notary PublicA,AEO Notary Pu R,'Ao' ti2�1 as�t!f Stet° go POW 4i This tppkip,., ., uc PIUNL;Iiy wiiYNicLcu III nN U-utitcLy .suu MU61. I �Ulll IlkJr�rl11-CU nig]I A ulctajUI the legal nvivner(O nfthe crthiPrt nrnnPrtv1_ and the nnnlirnnt nfrernrd in the enarPe nrrn,irled Annlirwinnc 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- 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE ftOOK OCT 2 0 2Q?1 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RY_ BROOK wwyv.ryebrootc.oriz _BUILDING DEP"I RTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE �216 • STORM SEWERS AND SANITARY SEWERS TUTS AFFTDAVTT MUST HEAR THE NOTARIZED STrNATTTRF. OF THF. LF.GAT. PROPERTY OWNER ATM BE SCTRMTTTFD ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL HE RETURNED TO THE APPLICANT .. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: 3j, Sue Zeitlin , residing at, 201 Country_ Ridge Drive (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; 201 Country Ridge Drive , 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. 1, ure of Proper Owner(s)) Sue Zeitlin (Print Name ol'Property 0m,ner(s)) Sworn to before me this 2 0 day of October f 20Q I (Notary Public) snznazl �yE BR��• w � 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR SSISTANT 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:- 2-0 / � � ` �� DATE' � � IC rr ! PERMIT# 2 ` ISSUED: kj_� SECT: BLOCK: LOT: IM LOCATION: �` t�� L�� << �' \ v' OCCUPANCY: -� ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION �, NATURAL GAS �V�l3V� 4 N o �/f 64\"(I( / L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL OTHER