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HomeMy WebLinkAboutPP22-109 : C o � N a, 00 00 CZ x `n w W = ( L z O _ s G4 0 o O A � z it Cq a s A w m _ w' w � H z Q O ° Q z C'� r _ Ln d o =Y _ ~ � _ ai p z a a � t a a U � _ M-- w u. O w © z G � oo Ln :s _ BumwNG DEPARTMENT VILLE OF RYE BROOK AUG 19 2022 938 KfNG,"ET RYE BgooK,NY 10573 VILLAGE OF RYE BROOK (914) -0668 BUILDING DEPARTMENT ww�t:i�y�ht•Qok.or� PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY Bl' PP#: =:-�r)0 7 Approve! Date: Permit Fee: S � �!- Approval Signature: Other: Disapproved- AV (fees are nod-refundable) Application dated, �'% —r3� is hereby made to the Buil ing Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove 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:15 Reunion Road SBL: S:124.65 B:1 L:56 Zone p/46 2.Proposed work: APP1Y Air IntegritV Test on Customer Natural Fas Piping Due to Leaks asper Utility come 3.Property Owner: Leon Goodman Address: 15 Reunion Road, Rye Brook Phone#: N/A cell#: 914-772-6227 email: a000die47@gmai1.com 4.Master Plumber: Paul A. DaSilva Address: 128 W. Sandford Blvd, Mt. Vernon NY Lic. #: 1495 Phone#: 718-866-3900 Cell#: _914-497-4610 email: dph1495@gmail.eom Company Name:DaSilya Plumbing & Heating Corpadress: 128 W. Sandford Blvd., Mt. Vernon NY 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 Ist Floor 2nd Floor 314 Floor 4'h Floor 5*Floor Exterior %/ 1 5.*List Other I quipmenUProvide Details: 1-Water Heater, 1-Forced Hot Air Unit 1-Cooktop (Notarized Signatures Required Next 2 Pages) 8/12/2021 Q L CIE IE AUG 19 2022 BUILD MENT VILLAGE OF RYE BROOK BUILDING DEPARTMENT ♦II LADE OF RY OOK __.... __ 938 KING STREET RYE BRO Y 10573 N (4-4)939-0668:~ , 1 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: 31, �� �'" residing at, (I'rini Hamel (Adlrrss ch�re)uti lip l 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; S t7 t)tV�yN _745WP pele _t�RaCL t � f lof �3 ,Rye Brook,NY. (.lob Addic.,,i 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. ( ignalure of Property Owner(s)) L e000 C- crDM*c4 (Print Name ot'Propeny Oune(s)) Sworn to before me this CLAUDIA UVALDO a of o> .� NOTARY PUBLIC,STATE OF NEW YORK ' NO.Ot UV6107856 QUALIFIED IN WESTCHESTER COUNTY COMMISSION EXPIRES APRIL 12,2024 -3- 8/12/202 t STATE OF NEW YORK,COUN OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (print name of indi%idual signing as the applicant) 4�2 her states that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the /"¢ �<LCl/i� for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,annmey,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 fork State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to fore me th' I Sworn to before me this Z..'gyture7('3T17ro'perty 20 0 — day of t}'(k 20 Z 2 Owner gnatu rcanl Print Name of Propeny Print Name of Applicant `,`%\\\\I I I I lllt �/' LAUDIA UVALDD .411, STATE OF NEW YORK . O�NgRON� ota Public "NO'01 U1l61O,, 56 s G pG /y rY QUALIFIED IN WESTCHESTER COUNTY Notary u c :'e yam: COMMISSION EXPIRES APRIL 12,2024 _ •a NOTARY O �' PUBLIC — (j1*"o No.01tE63e2qri6m:/a�C This application must be properly completed in its entirety and must include the notarized sign;itprc�)OFYNE`N the legal owner(s)of the subject property,and the applicant of record in the spaces provided. AppliAlionjI I I►1��� 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- an 212021 of Bkj� . BUILDING DEPARTMENT ZLDING INSPECTOR ISTANT BUILDING INSPECTOR VILLAGE OFRYEBROOK ODE ENFORCEMENT OFFICER 938 KING STREET . RYE BROOK,NY 10573 (914) 939-0668 FAX (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: C1�4e ) U \ V V \ DATE:[-L PERMIT# ISSUED: I SECT: ' BLOCK: I LOT: Z LOCATION: GS � n l ` ��r 1 Q CU ANCY: `y ❑ 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. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER a s U � y Y19 a. J LV ,�•� O Q, Q •= n r ONSrl M pq C _ CIS C U