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HomeMy WebLinkAboutPP23-072 a ■ a o = s � W � H � H V � ■ _ �--+ do M ►--� © a a � i cu CN o � z O � W � � u�►� ' Ci) uCN co SO P4 u z (> Ln H It UIr 40 V - a 00 F W A cn 0 z wo W a � Uoa v� H S ►� A. 0 � o .. w Op BUILD 6DEPARiTMENT VIL'n' E OF RYE ROOK JUL 13 2023 938 KIN C?\ ET RYE BROUK,NY 10573 f�4B VILLAGE OF RYE BROOK i.or BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION n '�f FOR OFFICE USE ON LY BP M PP#: Q 3—V / Approval Date: 1 4 ?FM Permit Fec: $ � Approval Signature: Other: Disapproved: (fees are non-rerundable) Application dated, *7 yh3 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. 1.Address:_�� GV; //-C,I /eoad SBL:11 +t16t0`�-77 Zone:/Q`—r0 2.Proposed Work: Lr -e t ts;h darnoq d�£'I,ve►- litge W1m .ekv T411S,#, �C / f' 3.Property Owner: �) ,s 176 0 Address: o2 a2 tVi /�Vvy Zd " Phone#: 7/7'-(�5S/ /�� Cell#:6?03-.773 email: mtt�'!�- i�4Zln`Il?Orr�vGn��s, 4.Master Plumber: 4EdlvQ fd J Vi Address:. y Lic.#: �Phone#: $7 ko7�jp Cell#:9/y r/Q3'a353 email: a'USG COIYJ!" Company Name: Lev Address: ---6f / 01— INDICATE FIX'I'URES& LINES`FO BF INS7'ALLF,D AS PF:R TIIE FOLLOWING SCHEDUI.F:: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor 2nd Floor Y4 Floor 41 Floor 51 Floor Exterior 5.*list Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 313/2023 STATE OF NEW YORK,COUNTY OF WESTCHESTER tN 1%l' / J V1 1-ilk"C ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and further states that(s)he is the Master Plumber for the legal owner and is duly authorized to make and file this application. That all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations Sworn to before me this t75 Sworn to before me this t� da of 3'A\' ,20 �'.� day of TL'sA t� ,20 2-3 St ature of Property Owner Signature of Applicant c-fd Mira kj Cd ward J. V, fo-JP. Print Name of Property Owner Print Nantc of Applicant USA inn*49Bl Notary Public NQTARY PUBLIC-LISA M INGRAO No. 010 Notary Public,Slate of New York Qualified in weslchesto( County No.01IN4956962 spy CoMpnlislon Explles September 03,20 Qualified In Westchester County ,�� This a i F 6f4�iiS�$F6� opus 3 L'64 tpleted 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- 3/3n023 D ECENE BUM Di12• MENT JUL 13 2023 ViL . E AF RY OOK 938 KING, i T;RykE ore ,NY 14573 VILLAGE OF RYE BROOK 14 =t1 _ BUILDING DEPARTMENT rob AFFIDAVIT OF COMPLIANCE VILLAGE CODE&216• STORM SEWERS AND SANITARY SEWERS THIS APPIDAM 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 WESTCHi STER ) as: 7f Mara Ossorio 22 Wilton Road rending at, (Print name) (Adikcsg where you live) being duly sworn,deposes and states that(4)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; 22 Wilton Road Rye Brook,NY. (Jnb 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 stormwatcr 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, (Sigi ture of roperty O�vucrLS)) Mara Ossorio (Print Name of Proinrty Sworn to before me this )') clay of �,.1. ,20 a3 �I (Notory Public) LISA M INGRAO Notary Public,State of Now York -3- No.o1iN M952 Qualified in Westchester County Commission Expires October 2,20a-< 8/12/2021 �yE BR(�k• cu � • 1982 BUILDING DEPARTMENT ILDING 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: , D.E. PERMIT# ISSUED:. —&CT: LOCK: LOT: LOCATION: �`—�� GCQ �� \,/� (!� OCCUPkNCY: ❑ Violation Noted \ THE�WQRK IS... PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION C �k� /// REQUIRED ❑ FOOTING V/ ❑ FOOTING DRAINAGE ❑ F UNDATION ,,Zr- NDERGROUND PLUMBING NOTES NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas -A ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER Tara Orlando From: Laura Petersen Sent: Thursday,July 20,2023 3:07 PM To: Tara Orlando Subject: FW:22 Wilton Road Laura Petersen Office Assistant Village of Rye Brook 938 King Street Rye Brook, New York 10573 Phone (914)939-0668 1 Ipetersen(j�ryebrook.org From: Pipeline USA<info@pipelineusa.com> Sent:Thursday,July 20, 2023 2:09 PM To: Laura Petersen <LPetersen@ryebrook.org> Subject: FW: 22 Wilton Road Hi Laura, Thank you again for setting us up for getting me the permit and the inspection so quickly. Attached are pictures of the sand for the backfill that was requested by the building inspector. If you or he should need anything further, please let me know. Thanks, Lisa Angelo Pipeline USA, Ltd. 845-621-5996 From: Pipeline USA<info@pipelineusa.com> Sent:Thursday,July 20, 2023 2:02 PM To: Pipeline USA<info@pipelineusa.com> Subject: 22 Wilton Road 1 Pics of sand for backfill as required by building inspector z G - i 5 t L i��[;�; ,• .'-� sir ol _ y j lop jm b. + y,E Y f�• y� 3 � \ y 'WA - ■\ . . lez y: f-\ ^ °46 . W I yyqq, � J ' 7 T I A - p . e - jr �• .r- it e , T ,NI, t �! 44 4 eo # _ �-7" J *hta J J - 9