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HomeMy WebLinkAboutBP22-198 f a f f 00 N w ON c QI � � • v o- � W = m o y FR M W r.f) f I� 00 v 0 17 N a tj v Q W 1-4 C o b Z0, H u, $ o a � tn O Q [�] N 0� N A Q N 4 , E = Q z M A oobv a cn aCN N O C -0 1 V} w n � yO Z . A w 80414 � � � W o v V U z oz 0-0 BUILDI I F RTMENT VrSE VILLA' E OF RYYIA i',OOK 938 KING STRtEE,r RYE BROO)14,NY I0573U ! 2 -( -0648� VILLAGE OF RYE BROOK www':irve roole:©re BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY:. Approval Date: SEP 2 1 10 �1 Permit#: �U Application Fee: $ O Approval Signature: Permit Fees: S 'y_ �- Disapproved: Other:, Application dated: U-12z-�a 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. 1. Job Address;1 I S k 9, S4 sec SBL: Ii , 1-? - 1 -S Zone: C' 2. Proposed Improvement. (Describe in detail): c �� ` ► ✓r:/ k,, n 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No:-)(- Yes: If yes,indicate: TIER 1: TIER li: _TIER fli: 4. 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: _Z _Yes: (If yes,please submit a separate Automatic Fire Suppression System Pennit application&2 sets of detailed engineered plans) 5. Occupancy;(I Nm.,2 fam.,comm.,etc...)Prior to Construction;(_ter,.-AF,�;G After Construction: Co-"a rl a tc I) 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: /4,i T T&A I( Address: Q,,e MA i ft ata. ��}� {,C4 Ia. )y I q.;0_3 Phone# )01-7`12-t-11-109; Cell#_.�,01 -7a(.- .11-1iW email: ,-utl eo.4 0._4h-.4 8. Applicant:_ t I iaa Address: 1070 Al Fcr.tit S krl,$�.Y 3� t,./,-ff d CT (%cfj Phone#409-A 1'7. _Cell 4-?03-'!76-3 965' email: . h--, ,,Or..� 9, Architect SC k cW A rr-1 .'i r J c,,1 Address: ill Rf fj 01 Phone# Cell# 716 -597 -`d031_ email: Kmove.11i '1,Clne'!'J�ij:s a 0 t2 10. Engineer krr-k rgl Address: III 61,,,acA Aae, a,.+Ejal !��' IL) ]Oi Phone 471 C.- -f Cell #_716- 59 7 - 9 q'� I email:.5 I I ; d!0 sCL r;o1a,u, 11. General Contractor. A U Q,,I(t �n s t rh r_� un Address: L0 70 IJ Fw—(- Q,� �/ �� e fQr�l,Li G�iLj� Phone#-5 0 iK-a31- ILL Cell#203 7,77.n-,3 rf 4S email: 12. Estimated cost of construction '3"i( 7`i-�L (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed eyutpinem.professional fires.and material and labor which may iv donated gratis,) r � � 13. Job Timetable:Start: '0(32t% Finish:_ I I `7`I 2 (li 811 M021 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. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: ":ft ��CCS• _,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 6—f 0.2 ral C o,l LrG f, 'r 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. 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. Sworn to before me this 13 Sworn to before me this day of S�iaTG�lC3�� ,20 ZZ-- day of ,)"kw , 20 Signaturco yowner Signature ofApplicant / } Michael F.McKeon.VP•'M&T Bank 0,+fh e�^✓ �Q C of!e- Print Name of Property Owner Print Name oaf Applicant 0/5 Notary Public Notary Public MARIA VICEVIC ROBERT OA CORTE NOTARY PUBLIC Notary Public Connection STATE OF NEW JERSEY My Commission Expires Feb 2a.2023 MY COMMISSION EXPIRES OCTOBER 20,2025 (4) 8/12/202 t