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HomeMy WebLinkAboutBP22-126 a � � N nn • � � � fr1 a, as �..y O r^ a II. y V J A �i y N .b wr.•i ( a a W OCL v YL O ram, a 00 �•y �; ON 1..1 HI O 3 0 4 v 0. F+i s a O W a � H U � � a A M 00 1-4 ° �0 �" a w0 . o- „ •v � N 000 SF . 10 ,5CZ0 ■ bH ro,o ° 0 A. h+�I � U UZ W )MEMO-+ v es A " V � o 0 ° was +lA W a oc a Ooz N v O O Z a )MEMO v 1 o u p vIlz Ln .. A a z ° p o U Wav -94141444;4;44;41414i4&414;4144444144944194;4144444-66414;96999 BUILD MENT VIL E OF RY OOK JUL Z�z2 938 KING ET RYE BR,. ,NY 10573 -0 ��-c VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: JUL Permit#:,1 ���/ aKp Application Fee: $ 7� ' Ab Approval Signature: Permit Fees:$ I O A6 Disapproved: Other: Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. I IN C / / 1f 1. Job Address: S Pr M r Q 5 c? ( F)N� SBL: / 9, 07.7 /"/+Ozone: 2. Proposed Improve ent. (Describe in detail): ak I, t4 f cT nn 1 c- 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: k Yes: If yes, indicate: TIER I: TIER II: TIER III: d. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System, FM-200 System,Type I Hood,etc...) :No: X Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: I - f4m t l After Construction: Q*r 6. N.Y State Construction (Classification: N.Y. State U Classification: 7. Property Owner: (I(`h M; l Address: 5 D r, W)t-a s Phone# Cell 414 438 14 3 3 email: 8. Applicant: �W�kddress: &1 WPAo � VL l�ht�c l'�11�y3_ II V 'luo& Phone# y 1 Cell#9 t1( 4910 Uc$a' email: 916ddo I N L, 0 QM 11 l .Cohn 9. Architect: Address: Phone# Cell# L email: II 10. EnG ineer: U I - ` Address:a C - S hi l��1 N d� Phone# g W Q p A"4 q Cell#14 6 I a I email:ham 1^ha P+o t . COm 11. General Contractor:%AbO N y �op6do �04 '(Address: a l W(-M Cl, R V,= LA?, W 1 10606 Phone#91q q N$ S9 ( $ Cell#Gl(y LAgo a.% Oa email: RWddoIN GeQYnfily rCoM 12. Estimated cost of construction $ H ►d 60 o 0 (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis) n Q 13. Job Timetable: Start: , "1 ' Finish: (1) un9nm B19LD� PAR. MENT VIL AWE OF RYE LA OOKJ� IU KING ET RvE BR ,NY 10573 JUL 14 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 NEWW YORK, COUNTY OF WESTCHESTER ) as: 3, V If' Loc- , residing at, ��j W^rw L, )Prin( name) (Address x%herc you Ii%e) 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; © -!) C 1 Imo! , 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 stonmwater 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. (5ignaitt A'Propcm Owner(s)) ?\o A P ­6 1 (Print Name of Property Owner(s)) "ltil Sworn to before me this 1;�_ da of , 20 c �- E VERRELLI ate of New York 6228152 (2) tchester County pires Sep 13,2022 on�nmi This application must be properly completed 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. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. S OF NEW YORK,COUNTY OF WESTCHESTER ) as: MATE,l i,D 1� 1_�L.w•T , being duly sworn,deposes and states that he/she is the applicant above named, (print name of ibiliviTual 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 K y'lm ;l I o e1 ci p C[ U G o*-+r l tV l for the legal owner and is duly authorized to make and file this application. (indicatJarchitect,contLWtor,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. By signing this application,the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. f Sworn to befor me is 12- Sworn to before me this day of 20 day of , 20 Signature of PrJperty Owner Signature of Applicant T Vtl� nt Name of Property Owner Print Name of Applicant Notary Public Notary Public MICHAEL VERRELLI Notary Public-State of New York NO.01VE6228152 Qualified in Westchester County My Commission Expires Sep 13, 2022 (4) v.Y••..�r ..•r.. ••.r•...••••r•• OF THESE DOCUMENTS AND SHAL RETAJN ALL STATUTORY,COMMON LAW,AND RESERVED RIGHTS, INCLUDING THE COPYRIGHT. ALL OESIGNS,DRAWINGS,AND Cs -� SPECIFICATIONS PRESENTED ARE AND SHALL REMAIN THE 0 PROPERTY OF THE DESIGNER.o � NO PART SHALL BE COPIED, • Z ! .. DISCLOSED,OR USED IN Z-- _ CONNECTION WITH ANY OTHER <C PROJECT OTHER THAN THE _ SPECIFIED LOCATION FOR WHICH THEY HA1lE BEEN H.OU DESIGNED WTT THE WRITTEN OF THE DESIGNER. THE WRITTEN CONTRACT ALONG WTH THESE DRAWINGS AND SPECIFICATIONS " SHALL CONSTITUTE CONCLUSIVE COPY 0 I OtA v Y EVIDENCE OF ACCEPTANCE OF D THESE RESTRICTIONS. IL Wool 0-0 -J, UJ .. t PERMIT# 4 88l.# G Z , Z•� , � . 6 �-so DATEMPROV 4:t I 77ti�,- -1 GI CL !lUu.D �fl�SPE ,��Ata9e o�Rye 6roo1�,MY � i�1O: DATE: �Lt�lzP7 DRAWN BY: C H KD BY: REVISIONS: L)LAtmcl C�o s !�-5 toZf_4-t - f 6 ��... L.kXK:) cis p P \LA 2 tp 0 + OD J) I 0 • 0 � � �-- J 6� IFE z uj Dn ' (2) z fV (j � 0 JUL 4 2022 uw � q- �/ILLAC�E OF RYE 1 BROOK w 0 �- Buil-DING DE-PARTI ENT v w ,. (L w