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HomeMy WebLinkAboutPP22-046 : . V N N a O 00 N 00 O ^ C 1 -1 O va CC p m Ch s yr M w W O � Nw W = C M i A a W ,� O 0 z en � z �' boo O LO PLO �4 a ® o cn z • p w w = A W x z _ o � w 00 � � z A � Q � ►� 00 't-+ rn " A V o W M�yr� 00x Fit w F +I cr} I�1 : H ce a o � oa w w o off CIOw © o cn V O � � N z w A o a z F ] 1-4 U I C4 R� W un [ECENED BUIL DEP MENT VIL E OF RYE OK APR 1 8 2022 938 K N ET RYE B ,NY 1057 ( VILLAGE OF RYE BROOK or BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP M PP M CDC-) /4Z'-__) APR 1 9-2W Approval Date: Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, oZ is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or renfove 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: a 2 L C'W 6 SBL: e3 g -- Zone: 2.Proposed Work: QW3 VJC?C� 3.Property Owner: A` ► {�{}0-C4 0 Address:_q Z LC'W f 1 Crqf' oii je Phone#: 60 3\E)?-, Cell#: email: CAQ0 1G0S4tQ.00L:,1 II CU[h 4.Master Plumber: Address: 2-6 Qfe_9_',,rnd PVL' Glm­,k.rd KA Lic.#: \2bJ} Phone#: q uA lfficr oc(D Cell#: email: [YY. Dhl~�S11t�S1V Qt�tYlf i M Company Name: Address: 2_b QVP_ )Md AN)e. n 'PI 10 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 I st Floor 2nd Floor 3,d Floor 411 Floor 5`1 Floor Exterior 5.*List Other Equipment/Provide Details: re n 1 ' cr E leak, (Notarized Signatures Required Next 2 Pages) 8/12/2021 BUILnOFRYE MENT D p VILOOK 938 DING ,NY 10573 APR 18 2022 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 WESTCHESTER ) as: ,p 1 �� Qy) , residing at, �(1*�( 1 �1�i,� D`� �I � — (Prin(name) (Address where you live) being duly sworn, deposes and states that(s)he is the applicant above named, and fiuther states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; yz `Lcwc i )f kvQ ,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. (Signature of Property Owner(s)) IRI 1 iIoI C�'P (PrA Name of Property Uwncr(s)) Sworn to before me this rJ�� dayof c 20 JENNIFER RIVERA 1 1 22 Notary Public- State Of New York N0.01R16388056 Qualified in Bronx County MY Commission Expires Feb 25, 2023 (Notary Public) -3- S/12/2021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: MctkJr L'y ,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 15-112 Sworn to before me this 17' day of 120 22 day of 400 1 20 ZZ 01 � A Signature of Property Owner Signature of App can .M \ )� or an PC4 - LlAhe�j Print Name of Property Owner Print Name of Applicant Notary Pub 7NO. O 7t� l 4must R RIMleted State of New York Notate 1 R16339056 388 in Bronx County ronx Expires Feb 25,2023 My CoExpires This applicatio p 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- 8/12l2021 E BRc�k 1932 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.or - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : H DATE: 17-7 PERMIT# y ISSUED:�I Z ECT: a- 67BLOCK:�_LOT: LOCATION: �� �A-sn L t 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 L.P. GASL _ ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION n \ •J ❑ FINAL ❑ OTHER cn * O * 4-, •� * fv`1 * CIO * V ` pop * a s s co 1-4 016 - . S w o Coo r 1-4 * z * . ct v o w o O U * V � cn —C� '' V Ga a a