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Home My WebLink AboutPP23-035 Ln N = M N 6� OI \ W O : a ' H a w O pq k Vcn = C p' a0 r M a v cis = O Z o (•� N a a o A Q = z , M z w ° o w � � _ _ 0 O = a w C7 a x COO A .., a in 0o F 00 0 � U z (> a : In Cl\ ON .4 � ) 0 00 0-4 ~ ¢� z w A �z w O a ►.• H ° zg x u W o0 w c z o � � o , N o w w °� a 0 � �E BRC�v,� BUIL MENT VIL E OF RYE K 938 KIN ET RYE B ,NY 10573 or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: ZA 1J Approval Date:_ MAR 1 4 2023 Permit Fee: $ Approval Signature: 11 Other: Disapproved: (fees are non-refundable) **************** *** ************************** ************************************************** Application dated 3 is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install an or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumin or will be in conformance with all applicable Federal,/State,County and Local Codes. 1.Address: SBL:��/.(�J J�r Zone: 2.Proposed Work: - / "'-'M I aeol) - 3.Property Owner: A CL Address: Phone#: Cell#: email: 4.Master Plumber: Address: Lic.#: Phone#: Cell#: it A a,C Company Name: .. .�lr!1 Address: C 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 1st Floor 2nd Floor 31 Floor 41 Floor 51 Floor Exterior I 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) i 3/3/2023 BUIriDMENT VELE BROOK 938 KINGROOK,NY 10573 668�` 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, (Print name) (Address where you lice) 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; 1 , Rye Brook,NY. iJuh Addre,�) 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. (Signattire of Property(hcner(s)' (Print Name of Property Uwncr(s)) Sworn to before me this of _\g_cc\N , 20_�I� SHARI MELILLQ .Votary Public,State of New York No.01ME6160063 _�n." L�L Qualified In Westchester County (Notary Public) -'ommission Expires January 29,202J -3- 8/12/2021 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Osi4oOIL ,being duly sworn,deposes and states that he/she is the applicant above named, n individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. 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 Sworn to before me this l day of Cy1 Q rG ,20 day of 20 �3 Signafure of Property O er Signfure of 4TplicapJ &l9-Ei�1� ,�:Gf � 1fjfq�'v Print Name of Property Owner � �„ Prin Name o4 Appli ant Notary Public SHARI MEULLO Notary Public Notary Public, State of New York SHARI MEULLO No.01ME6160063 :Votary Public,State of New York Qualified In W"tchDster County No.OIME6160063 Ccmmisslon EXpi res January 29,2010 Qualified In Westchester County This application must be properly completed in its entirety and must mclt8'� rt �0t3z�iu�e(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- 3/3/2023 0 * o * U .t �4 * * * v L�, F Ln c � U Z Q co Q * o t0 * U c a a Z W w � � * a � � f•, -� CL, � � bn M ON * qj * � p * N * t 3 U o O C �E BRO o`` tim '9a2 BUILDING DEPARTMENT 61JILDING 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 - - - - - - - - - - - - - - - - - - - - �1 ,\ ADDRESS :— (� (vo (-a-� y DATE: ZUZ3 PERMIT# -�� ISSUED: 2 CT: . 3�BLOCK: 2 LOT: LOCATION: `� \\ �'� C , <<,n-�OCCUPANCYA ❑ 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 0 NATURAL GAS I C� p L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER �E BRcb, cu � t7 '9,32 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 - - - - - - - - - - - - - - - - - - - - ` C t ADDRESS : ( v DATE• � 2 C) PERMIT# �` ' I, ISSUED: SECT: BLOCK: LOT: LOCATION: Y 1\CA �\ .1�� 1 C. C — OCCUPANCY: 1 VIOLATION NOTED THE WORK IS... ❑ ACCEPTED REJECTED/REINSPECTION SITE INSPECTION 1 REQUIRED Al FOOTING ❑ FOOTING DRAINAGE �� ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER �, `e C� ❑ FINAL PLUMBING ❑ CROSS CONNECTION l "� ❑ FINAL ❑ OTHER t o(+ n T N � ltci �c�