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HomeMy WebLinkAboutBP22-218 a a ■ _ � a N o E CV W q ■ G\O ■ Q•I � � � 1ay '� ��i I ■ a � � ►fir � H W ■ 44 o � = 0.i A W r j v f�4 a r Lncs M a� hT+l w C 2 a V s = 0 z r- 9 z \ O w 0 W 9 0 a w ■ OW bu 14, v o b 7 N ° 0 q w ' ■ Q .S V O A O0 �} d ° p y O O � Q ; �-� ■ W ("� o W H � ° � 00 �` '�^ 'A w H w z ,"� o a `� ■ o z W � s °' � O z y V o o o � z a � o v� � M c07 V `r w i Q � � v CA ,—. W W � un � -es Ca v- to M� cM O W '�' o " q cu z s MCI � � w 00 ON U o w 2 a �A4 f� " � _ � " p v yw z a � o a I-�■1 W F-i O z Z W O U O O ° ■ � � C7 � A z O � i � � o � � Zcn Ei wdQ .Y u q � L e W 0 •• A C1r z w ,�J+ �Y0-41 y I ►rl Af 1� l� `�, Vd1 9 e P�� tut P� P� P� P���� �■ f� i� !�1���������1�� W����� W�� N w BUILD MENT Q 0 �/�� VIL OF RY I 93$KING ET RYE BR ,NY 10573 OCT 2 5 2022 d -� VILLAGE OF RYE BROOK OK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: OCT 2022 Permit#: ��/ pp Application Fee: $ Approval Signature: Permit Fees: $ 630 Disapproved: Other: >t k 9rlF******'k*9F1F eF 1F lr'lk'k lF tk it*'k***1F'lfiF*7efF*:ka'C kifhkklkxx>Y�C'k:ei'r�;*****df'V('fF'Jt iM'XsY:F iF is****a49r Jt 54***�'**d[*****at is*sM SF�'*****a4'e*i'!sF*:F*�** Application dated: 10 Z Q Z 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 e"xistink building,or for a change in use,as per detailed statement described below.1. Job Address: p SBL: A)9,5/p —1 31 Zone: 2. Proposed Improvement. (Describe in detail): 2 Q 1r 010 S J r gjj 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: X Yes: If yes,indicate: TIER I: TIER Ih TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSI,System,FM-200 System,Type I Hood,etc...) :No: )( 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: 'P(kIM After Construction: 6. MY State Construction Classification: N.Y. State Use Classification: 7. Property Owner:&LM Q= 60SJ11'1t. Address: '001(4 15rbyV_ O Y I OV 9 Phone#gig 810 8 z- `2 Cell# email: a c& 4oett OF 9"X40.LoW^ 8. Applicant: En'CA GWS litho Address: t�lo[(,y ( A, Phone#1410.3ln- S2ty2_ Cell# email: (!YIC& goSllhr 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: I' — w e, Address: /3- I-W-se '"Cre- ©A h1h.0 /J)" /D S G Phone# 'Z j(t 0ZOG Cell# Cj 1 y-V P1- 1&Y email: 12. Estimated cost of construction $qzc D 0 O (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: (I) 8/12/2021 BUILD - MENT VIL OFIRY OOK 938 KING 11 Q ET RXE BR ,NY 10573 wwwww,�*wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww*wwww*�iw,t***w�rw,�ww**wwwww*w**wwww*w,�w*w**wwwwww,�*wwwwww 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: ns I ke residing at, y t I u LaVL- (Print naive)ri (Address Where you lire) 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; b H o 1w (Lia 0 e � Rye Brook, NY. (Jot)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. (Signature of Property Owner(s)) Cn (.C' r.o s lL)C' (Print Name.of Property Owner(s)) Sworn to before me this f day of ()GTr,bCA , 20 L 1— (Notary Pub"MT Np�ryRMIM C KY. Np.01LA1�09242 OualW in Westchester (2) COMM104,Fxalres P O.2 8/12/2021 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: , being duly sworn, deposes and states that he/she is the applicant above named, (print name of individual signing as th plicant) and further states that (s)he the legal owner of the property to which this application pertains, or that (s)he is the 0 LA)Y)Q_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 m""e��this I( Sworn to before me this Z , day of DCiry��(. e 1 , 20 )—L- day of d c_r".,n , 20� Signature of Property Owner J Signature of Applicant Eh Ca GoS lfb e C_n'caI Print Name of Property Owner Print Name of Applicant ��'& '? IM4 _.�o Notary Pu is Notary Public Mod Gir RMW C.Lau s�°ofNY. ry OPubIcLA60142NY. 0�1ILA � no Co Fxo 23 (fir Pob.2& .7�. (4) 8/12/2021