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BUILDING DEPARTMENT ® FUENIED
VILLAGE OF RYE BROOK
938 KLNG STREET RYE BRooK,NY 10573 J UN 2 9 2022
(914)939-0668
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
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FOR OFFICE USE ONLY:
Approval Data c 1.j1- 2 1 2012 ' d' Application# - —
Anrsro� cl Cinaturc: ARCHITECTURAL REVIEW
BOARD:
Disappro-wed: Date: If
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# _ Secretary: ZV
ZBA Approval Date: Case#
Other:
Application Fee: �� Permit Fees: I CDC)` r
rf FENCE / WALL / GATE PERMIT APPLICATION
Application dated: b 12-9 I2-0-L ?--is hereby made to the Building Inspectorof the Village of Rye Brook,NY,for the issuance of Permit
for the installation,construction,,rr;pair or replaccment of a Fence,Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code of the Villageof
Rye Brook,as per detailed statement described below. Swimming
npool fences must conform to the State Code.
1. Job Address: I 9 L LL C Fp I l _D (
2. 0ccupancy/IJse: tt tMA t-1 C E 0 0'6
,
Z
SB.I..l1: I '� 7,one:
3. Proposed Fence/Wall/Gate(describe in detail):
5j S A t 1 I 0 YJ b A F T H W H /t 11 (C Y 6 ih 11' - AAi - r i Q)
�L- c tr' t' R PA C V_ JAE Q QeyU - APP Rd MAl-6I-I T - tAj i (JTAjES
4. Property(honer:f A H e L M b e SA a
Address: R L!.C FAI LYL 1 b L
Phone# �Q-4 �r�_ 5(�,b Ceu# 6 D9- 310 S� (�email: FAPcEm ,
Applicant: 1Fp H E E M ,J !✓5�1� — --
Address:_1 9 BUIC ELL P—YE
Phone# C0 17 y Cell'# 60,+ email: S
Architect/Engineer:
Address:
Phone# nn Cell# email:
Contractor: _--5dStrM _7nMA 1\)F CL1 , ( 017A L Ffwc i, 4 �.D (nOtiV90 CV(D,(f
Address&Phone: �0 L n t-k IU od AVE, & nn1�]�11 f li 1L.LE1 N Y L D "!II. —�j?-�i
5. If building is located on a corner lot,which street does
it front on:
6. What is the estimated cast of construction 4 � 6 S o • o 0
(NOTE.:The estimated cost shall include all site improvements.labor.material,scaffolding,fixed equipment,professional fees,and
material and labor which may be donated gratis.) QQ
7. Estimated date of completion: 0' /2 6-2 Z,
&12/2021
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.
RRRRRR RR RRR#R#RRR*RRRRkR*RR*kk*RRx RR RRR###**kR*#R*#R#**kR*RRR#RRRRR*RkRR#*#k*R*kR*kk#*RRkRRxRxx xRxR RRR RRx*
s'rATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
A1-4_►, L' M D I:C A U ,being duly sworn,deposes and states that he/she is the applicant above named,
(pant name of individual signing as the applicant)
and further states that (s)hc is the legal owner of the properly to which this application pertains, or that (s)he is the
for the legal owner and is duty 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.
Swam to before me this 2-Cl* Swom to before me this
day of J J 1 V , 20 day of , 20
v..
a re of Property Owner Signature of Applicant
VAPI_, rM USA-1
Print Name of Property Owner _ Pant Namc of Applicant
?�� b'_ y\1
Notary Public Notary Public
SHAM MELILLO
Notary Public,State of New York
No.41ME6160063
Qualified In Westchester County,
Commission Expires January 39,20
i311212C121