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HomeMy WebLinkAboutPP22-158 4 4 4 9 4 1 a pQ N s V W � ° 15 1-4 W oo z A a ^ d o vcon Z o z o Z K, G � ;) �\, j x00 � ► x � W 96 O U as w a � U o0 O U oG � U er w t1a w H O �2 e W Z O O p w V V P. z w A o 05 4 BUIL E MENT DEC 15 2022 VIL OF RYE K 938 KkNd,_ ET RYE B NY 10573 VILLAGE OF RYE BROOK (914)9'�'9' 939-5801 BUILDING DEPARTMENT \Ww or PLUMBING PERMIT APPLICATION FOR OFFICE USE ON Y BP#: PP#: Approval Date: 2 i� Permit Fee: $ / Approval Signature: Other: 1 Disapproved: (fees are non-refundable) ************************** ***************************************************************** Application dated, %o� 5—��� 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 lumbing work will be V formance with all applicable Federal,State,County and/Local Codes. 1.Address: SBL: %c3`��S�—/—a 7 Zone: 2.Proposed Work: 3.Property Owner: I ' Address: Phone#: Cell#: email: R 4.Master Plumber: Address: Lic.#: tPhe#:A� Pbasqcell#: email: •Ccg Company Name: dress: INDICATE FIXTURE 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 1 st Floor 2nd Floor 3°'Floor 4 Floor 51 Floor Exterior i 5.* List Other Equipment/Provide Detai JAA I(Nrta iz d Signatures Required Next 2 Pages) -1- 3/21/19 STATE QF YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (prin a of in vtdu st 'ng 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 for the legal owner and is duly authorized to make and file this application. (indicate ar i t,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 15 Sworn to before me is 15 day of ,20 � day of 20-1— f Signature of Prope er Si afore o pplic Print Name of Property Owner Prmt Name of Ap icant Notary l0lic GREGORY M.RNERA Notary bli ERA Notary Public,State of New York GREGORY a RN �Y Public,State of New York No.D1RI6441398 ew 98 QtWirted in Westchester County No.W stche to Co missaon Expires September 26,2o,, is laII In Westchester County , Commission Expires September 26,2Q, 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- 3/21/19 BUII.D � PARTMENT D V VI E OF RYE BROOK 938 KING ET RYE BROOK,NY 10573 DEC 15 2022 ID (914)9 4�FAx{914)939-5801 VILLAGE OF RYE BROOK yo BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §21 G-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, A Mkr ET residing at, Okuk-4q (Print nrnnc) (Address where you live) 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; DG Rye Brook,NY. (Joh 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 ol'Pro rty(hatter s)) i Print Name ul`Propcny Owncrl�ll 11 Sworn to before me this i day of l�frl (�� , 20 (Notary Pt lici GREG©RY M.RIVERA Notary Public,State of New York No.DIRI6441398 Qualified In Westchester.Cot(nty 3_ Commission Explms September 26,10 3/21/19 E BRC��• BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑:,ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:- DATE: PERMIT /✓ # � ISSUED. i' SECT: BLOCK: LOT: LOCATION: OCCUPANCY: 7 l ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION L �` ❑ UNDERGROUND PLUMBING �2- NOTES ON INSPECTION: ❑ ROUGH PLUMBING SV/ ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER BR°°� Village of Rye Brook Public Works and Engineering Department J �O� 938 KING STREET•RYE BROOK,NY 10573 . 1932 . (914)939-0753 FAx(914)939-0242 INSPECTION REPORT Address:ZF 6 )(AIV / Date: Z 2l 7 Name: 1/�f J�'a4/e34 Location: Permit#;"Z - fl' one: Email: Work being Inspected: i�w+or�� Work Inspected is: pte Rejected Re-Inspection Required Violation Noted Code Section Code Section: Action Taken Code Section: Action Taken 118 Erosion Sediment Pass Fail Violation 210 Storm Water Pass Fail Violation 135 Refuse Pass Fail Violation 215 Street Sidewalk Pass Fail Violation 213 Steep Slopes Pass Fail Violation 235 Trees Pass Fail Violation 216 Illicit Discharge Pass Fail Violation 245 Wetlands Pass Fail Violation Other: Pass Fail Violation Notes: Ali , yr &j el*1,e, Diagram: Signature