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BUII, t9EPA R�MENT
'V E OF RYE B'ltOOIC R 1APR 17 2023
938 KING ET RYE Bw'K&'NY 10573
�c VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY! �y `
Approval Date: i P it# %^JC Application#
Approval Signature: : ARCHITECTURAL REVIEW BOARD:
Disapproved:. : Date:
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
Application Fee.& — IISPermit Fees:
ROOF PERMIT APPLICATION
ADDlication dated: is hereby made to the Buildine Inspector of the Villa¢e of Rve Brook.NY.for the issuance of a Permit to
Re-Roof an Existing Building,as per detailed statement described below.
1. Job Address: 21 Talcott Road, Rye Brook, New York 10573 SBL:,/35�S --/-78 Zone: I`j C4
Property Owner:David Wegweiser&Helena Krodel Wegweiser Address: 21 Talcott Road, Rye Brook, NY 10573
Phone#: Cell#: 917-553-5636 email: david@davidalanjewelry.com
2. Applicant: David Wegweiser Address: 21 Talcott Road, Rye Brook, New York 10573
Phone#: Cell#: 917-553-5636 email: david@davidalanjeweiry.eom
3. Roofing Contractor: INFINITY ROOFING&CONSTRUCTION CORPAddress: 12 FREDRIC ST, NANUET NY 10954
Phone#: ,Cell#: 845-587-0193 email: nfinityroofny@gmail.com
4. Job Description,list all Methods&Materiars:
5ee c4wc
5. Estimated Cost of Job: $ $13,000 (NOTE:The estimated cost shall include all site
improvements,labor.material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.)
G. If comer property,indicate street frontage:
7. Construction Type: NYS Construction Class:
8. Number of stories: 2 Height:
9. Is garage being re-roofed:No: O•Yes:(vj Attached No:O•Yes:(.4Number of Cars: 2
10. Is roof peaked,hip,mansard,flat,etc:
11. Estimated date of completion:
AM7f XY)1
Please note that this application must include the notarized signature(s) of the
legal owner(s) of the above-mentioned property, in the space provided below.
Any application not bearing the legal property owner's notarized signature(s)
shall be deemed null and void, and will be returned to the applicant.
RR##RRA#R#R#R****R*RR**RRRRRRRR*****R*R***RRRRRR*RRRRRRR RRRRRRR R*RRRRRR*R Rt RRRR RR**RRR*****R*R***R*RR*****
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
David Alan Wegweiser ,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 Whe is the legal owner of the property to which this application pertains, or that Whe is the
for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent,attorney,eto.)
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 tlus
day of 20)a_ day of , 20
4Si RM(Q
perry Owner Signature of Applicant
ser 'AQ�_VICA_ IGY Y Y W� 1
Print Name of Property Owner Print Name of Applicant
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Notary Public Notary Public
SHARI MEI ILLO
Notary Public,State of New York
No,01ME6160063
Qualified In Westchester County.
Commission Expires January 29,20:,_
AMIM A