Loading...
HomeMy WebLinkAboutPP22-019 , s e ■ a x N W O e v W N a r1 W � r' e W z Q41 = p � � w z o = z ■n,� ■ � , _ A � 00 V C IW—i w o V , Pf, V 1-M O W o U \ vz cn W MCI V U C�7 Q o o o cn a cn y�BR Cv D [EC Z ME BUIL E � NT VIL E OF RYE OK FEB 6 2�22 938 KiN , ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT .or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP Approval Date: 2 �� �—(�`� Perin it Fee: $ Approval Signature: Other: Disapproved: (foes Are non-mftwdable) Application dated, is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install an or emove 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: 1'7* S.9-ip(-9 �,,T SBL: f /, D7 - Zone:(�1! 2.Proposed Work: / 7 o t Lt/r! V lY „ 3.Property Owner: WIN P-006F, hXIVi LU— Address: Z4'106 913Y-V ftftzit p AM 64-M4"t&E•c4y" Phone#: -! `` 1- /Cell#: email: tom :_z[ W h�.jA2te e iYr+ 4.Master Plumber: /hc/401 �f /"!/ Address: IS Lie.#: Phone#: Cell#: /'}- ©3-6 c�lremail: AIM 1() _1 ie4 R��U M Company Name: �`� e4 "(�� �/�r, _Address: 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 1 st Floor 2nd Floor 3`d Floor 4a'Floor 501 Floor Exterior �. �� ��� l 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 8/1 21202 1 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: tUitk- ft" ,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 L&OP- f`— for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,allomey,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. 3t- it 'o Sworn to before me this Swor-rt to before me this day of 20 U, day of 'J 11, 7 otary Public ature of ttroperty gv,� Signature of Aporc t Commission Exnir s WT- ,' � L��l � d Print Name of Property OwnrrACItW Print Name of Applicant o 7 Pub li KFL1Y SA�1Dl.CR otary 1Pnblip SnN'�! FR Notary Public, P'~;te of New York 1 No. 0'-::. . Qualified in W :stche-ster County Commission Expires March 9, 20 D— This application must be properly completed in its entirety and must include the notarized signatures) 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- 8/12/2021 BUILD EPAR MENT V>EL aF RVE, 0 FEB 16 2022 938 KING ET RYE BR NY 10573 4 '� � VILLAGE OF RYE BROOK 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 WESTCBESTER ) as: 34, lb"_15 , residing at, V_VG (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; 13� S F- , 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. 210kre ol'Pr perry Qtrrrf(s)j i (Print Name of Property W"""(s)) '-04r- 3 5K Sworn to before me this day of ZA-JJ AP) , 20 IV otaV Public Kr_LLY SAN'rX.ER Notary poi i;r_, ,,re c, t\lew York N 00alified in County Commission Expires March 0, 20;IL y -3- 8/1?J2021 �E BRcb O�` tim cu � 1982 BUILDING DEPARTMENT ❑$UILDING 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 : ) q DATE: PERMIT# ZZ O 1 ( ISSUED:Z'/7-lL SECT: 1 Z,� BLOCK: LOT: x LOCATION: , `e S S Ot ,S UI" C 114 OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... D ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION J NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER r - ' r- h ALL !