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BUILDING DEPARTMENT D E(( rE �j rF�-
VILLAGE OF RYE ROOK
938 KING STREET RYE B ,NY 10573 LIAR ' 2�22
(414)939-0668' VILLAGE OF RYE BROOK
ter— BUILDING DEPARTMENT
FOR OFFICE USE ONLN':
Approval Date: APR 2 5 *ermitvz'rp'�C'- = Application# "-9(0- 814
Approval Signature: ARCHITECTURAL REVIEW
BOARD:
Disapproved: Date: 7117
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
Application Fee: Permit Fees: �i r
FENCE / WALL / GATE PERMIT APPLICATION
Application dated: —off r4-- is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit
for the installation,constriction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code of the Village of
Rye Brook,as per detailed statement described below. Swimming
pool fences must conform to the State Code.
1. Job Address: �� FUG 1.-1 lr1 1�117r 1 tl a 1 I I I JY�D � � 4�S�
2. Occupancy/Use: /—��'�9 S.B.L.#: �01/� ��^ �� '7 Zone:
3. Pro osed Fence/Wall/Gate(describe in detail): i 9
1' wV,-k Lt w O-- j
4. Property Owner: S 1 tAlcv)cuopj
Address: C l VlU( ` V� � N� S
Phone# 1 1 �� L�aL S Cell# email: I-Q0(1 R u1 S C rd 10 I rn
Applicant: Ste- CL��V C p YK) V'j
Address:
Phone# y /�1 Cell# email:
Architect/Engineer:
Address:
Phone# Cell# email:
Contractor: Of S)q N
�}
Address&Phone: ` 4 C0 u 1
5. If building is located on a corner lot,which street does it fron�t on: ,�
6. What is the estimated cost of construction • fta) t I` Ol �ZD V
(NOTE:The estimated cost shall include all site improvements,labor,ma eria,scaffolding,fixed equipment,professional fees,and
material and labor which may be donated gratis.)
7. Estimated date of completion: C '--�-o Z-
5112/2021
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:
,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.
(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 Sworn to before me this 3
day of '��'�l�1r(^ �� , 20 2J- day of fne,( L , 20 Z
0 rx
Signature of Property Own Sign re o pplicant
PAS So,o L2�y\ 1.A w (ICA Tj
Pri axe of Property Owner Print N of Applicant
;klc
No ublic
SYN GEORGES ROBYN GEORGES
NOTARY PUBLIC,STATE OF NEW YORK NOTARY PUBLIC,Registration No.01GE6132219 Registration, YORK
STATE TE OF OF NEW
EW Qualified in Westchester County,, 19
Qualified in Westchester County
Commission Expires August 22,20�' Commission Ex ires August 22,20�
811212021