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W x W Qa � BUILDING DEPARTMENT �CIEWFF_ VILLAGE OF RYE BROOK JUL - 6 2023 938 DING STREET RYE BROOK,NY 10573 (914)939-0668 VILLAGE OF RYE BROOK www.ryebrook.org, BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: Q Approval Date: JUL 0 Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, 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 plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. I.Address: 7 /_e_S / SBL: S�7­ Zone: 2.Proposed Work: l� .�/.' 7 � 3.Property Owner: 5046 d •%.. 4rwr9 kg Address: 15; /es AW�A Phone#: g0�''�' 3 3 3 Cell#: ef email: 4.Master Plumber: Address: ✓2T . Lic.#: Phone#: Cell#:� 3 Jr 63V9Zemai1: 9/171, fql Company Name _ ,#+r � tic r ..address: J-e— 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 I st Floor 2nd Floor 3`d Floor 4,h Floor 5"Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- 3/3/2023 STATE;OF NEW YORK,COUNTY OF WESTCHESTER ) as: art u—i�- 77 ,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 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 0 Sworn to before me this 4157 day of ��1--`li ,20_2a_ day of ,20 2-3 &raitore of P#6erty Owner /Signature of Applicant { 'JgGp(Sk 1?4��/z ,/z r�Z.���c��1v Print Name of Property Owner scoPrint Nam pp ' t TT yV.CRp,►G %'Wry pU 10 { 639o56'7r REG Nd-©Cp1 f S 04115f2027 Notary Public 000 44SS� Notary MIRIAM T GRIGERA TQualified Public New York in Westchester County mission Expires Jul 11,2024 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. 3/3/2023 BUILD MENT R E C U U V E VEL OF RY . OOK J U L - 6 2023 938 KING ET RY>� BR ,NY 10573 4 VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANTI'ARY SEWERS THIS AFrIDAVIT MUST BEAR THE NOTARIZED SIGNATURB OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED PZANG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORKS WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: residing at, 1S (Print name) (Address where you lip e) 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; S JE11S Rye Brook,NY. (Job 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. —a 4 A (" ature n, tv Owner(5)) (Punt Name of Property Owher(s)) Sworn to before me this day of -�/�� 20—_ ( otan Riblie) pubw of�Yo* NOWY -3- 8/12/2021 �Qy6 BRC��• o tim �'• �9b2•�' 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: SECT: BLOCK: LOT: LOCATION: rJ / OCCUPANCY: y� ❑ Violation Noted THE WORK IS... PASSED ❑ FAILED /REINSPECTION ❑ SITE INSPECTION u.>� 1 j� �. \f-y "'ffs REQUIRED ❑ FOOTING i 1 ❑ FOOTING DRAINAGE ❑ FOUNDATION ,,Jj-'UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas - ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER Laura Petersen From: UDig NY Exactix <tickets@exactix.udigny.org> Sent: Thursday, July 6, 2023 6:47 AM To: Steven Fews Subject: Message from UDig NY ****EMERGENCY**** DIG REQUEST from UDig NY for: VIL RYE BROOK Taken: 07/06/2023 06:46 To: VIL RYE BROOK PRIMARY Transmitted: 07/06/2023 06:46 00001 Ticket: 07063-000-051-00 Type: Emergency Previous Ticket: ------------------------------------------------------------------------------ State: NY County: WESTCHESTER Place: RYE BROOK Addr: From: 15 To: Name: EAGLES BLF Cross: From: To: Name: Offset: ------------------------------------------------------------------------------ Locate: ENTIRE FRONT OF PROPERTY INCLUDING BOTH SIDES OF RD NearSt: MEADOWLARK RD Means of Excavation: MINI EXCAVATOR Blasting: N Site marked with white: Y Boring/Directional Drilling: N Within 25ft of Edge of Road: Y Work Type: SEWER LINE REPLACEMENT Estimated Work Complete Date: 07/10/2023 Depth of excavation: 5 FEET Site dimensions: Length 75 FEET Width 4 FEET Start Date and Time: 07/06/2023 06:43 Must Start By: 07/20/2023 ------------------------------------------------------------------------------ Contact Name: MARCO DELIA Company: DELIA EQUIPMENT CORP Addrl: 32 JOSEPH DR Addr2: City: CARMEL State: NY Zip: 10512 Phone: 914-714-4816 Fax: Email: deliacorpny@yahoo.com Field Contact: MARCO DELIA Alt Phone: 914-714-4816 Email: deliacorpny@yahoo.com Working for: HOMEOWNER ------------------------------------------------------------------------------ Comments: WORKING ON BOTH SIDES OF THE STREET. EMERGENCY, CREW IS ON SITE NOW, THIS IS A THREAT TO LIFE/PROPERTY/VITAL UTILITY. Lookup Type: PARCEL ------------------------------------------------------------------------------ Members: ALTICE USA CONED i