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Home My WebLink AboutPP22-120 a , a ■ = Q N N _ cq N N cd ` N = 44 Qy �. ■ 66 U V J W Q) _ R. w x u P� ■ o l ti = INN* v tup W = ■ � � M lfa � a U : W Z J,4 z � � 21 r � W 5 a co u _ } Q W oo Z ti w U C)s FBI = O U uz W M-1 V) G1 A 1�4 � o z "T, oD F� A 0 W o o v U w A � W o zo Oa o � �Lp Ha � ao z w A o � r+ w z a ° w � F' � w o@ ` I Nil 91 W x � -- E C M V C BUIL MENT VIL E OF RYE OK SEP 15 2022 938 KIN ET RYE B NY 1057'3 ti VILLAGE OF RYE. BROOK . BUILDING DEPARTMENT .or e_._._.... _..__ PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: _ PP#: c3 Approval Date: JPermit Fee: $ Approval Signature: t AA Other: Disapproved: (fees are non-refundable) ************************************************************************************************** Application dated, �S e�� is hereby made to the Building 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: W �ltX�t V� SBL: I' _ _C)�5 Zone:e 2.Proposed Work: • S CaSCK knvse, 3.Property Owner: &0QCk k-MOS e• Address: _ e, Phone#: gQV0 ' '�5 Lc7 • LkVZ5 Cell#: email: ''••,,��r KV-d J5e_ l 4.Master Plumber: �-Ooeyic L� omr, Address: 1� W,,YW I �` elhW1 Lic.#: �j Phoone'#: q,!_•_-Ii,,0}� Cell#: 414. 14'"�'T email: r l bV A1.� !b �401 •e,OW Company Name: 1S.4q Rt�y1W! i Address: 5 s 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 4`h Floor 5`h Floor Exterior 5.* List Other Equipment/Provide Details: �k 16LSL`eentQ (Notarized Signatures Required Next 2 Pages) 8/12/2021 STO� ,F_N `W NEW YORK,COUNTY OF ESTCHESTER ) as: L-1J(M eS ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and fiulherstates that(s)hc is the legal owner of the property to which this application pertains,or that(s)he is the v' 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 5� Sworn to before me this l5 day of ,20 a day of ,20 � Signs a of Pr rty Owner Signature of Applic t _,/ P sec V'4wC4 Do L Print Name of Property Owner Print Name of Applicant 0 1�p ota Public oti-PublicPublic L?SA DICIOC USA DICIUCClo C}O 13otary Public - 3tate of New York INotarY Public- 3tate of%,,w York Nc 48t9c30 Ne 1919030 Cert mpAe File it Westcnesior County C&Mcfft fide to westuvstor^ My Commlwion Expires: �f 3►1�a(p Aston Explrex-71 a t / 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. 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- 8/12/2021 BUILD ,NG DEPAIqMENT VIL E OF RYE . OOK 938 KINGtET RYE BR ,� ,NY 1057 SEP 15 2022 gX 0(> - -VILLAGE OF RYE. BROOK •. g 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: residing at, e(b UV(X.t6A4 606 (Print name) (Addre, vu like) 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; t Vi✓6 , 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. lF (Signature of Property Owncr(s)) �e bQc eQ �.vu�see (Print Nsmc of Ploperty Owncr(s)) Sworn to before me this 115-6 day of , 20 a? t to Public) •Sa�1dx3 umisstwwoo jelsoumsaN, x Bq� oluoljlllao 0CCG h* D14 -3- Ik ARON)c al24c . ))lano nieloN 0I000101Q dStl 8/12/2021 Q4e BkjC l7 BUILDING DEPARTMENT /ASSISTANT UILDING INSPECTOR BUILDING INSPECTOR VILLAGE OF RYE BROOK ODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 I www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:— I 6 v DATE: 1�PERMIT# ' ISSUED: SECT: t336 BLOCK: ' LOT- - LOCATION: G -` �\ `'� ` `� ^ I OCCUPANCY: ❑ VIOLATI NOTED THE WORK IS... ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ULATION NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER C4 Cd k � . � q / � 2 2 ] k = ° ƒ u G ƒ \ k e k k } § k Q Q ? 9 /k } / § k / ) �� . a 96, cl k cc — � d � ^ ` � ) •�_ � � | a � > to k gj e / 9 2 c. � - ƒ � o . . � \ \ § 0 ) k } � O .. o U . to - k � 0 2 0 / § 2 < t f E E