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Home My WebLink AboutBP23-130 _ ■ ■ N "Ow z s A s F+1 v � ■ i � � � ° •� o, Q o ° ° W 0 A ,O/ W >1 Z e g co 04 En z ° vim A ray M fir+ W •d u j. y 41 O o 0 0 o x x W " z � � 01% W ° � � y V o � Q � W 0 El C y Ln . ~ y+ N O zAa v8 .1 p ►0-4o o ° W z z o a vg v, ■ U II1I fi, o " E. c `� a � - Z O o U o g cvU , N •• O P� eJ u + �p p CC IEWIF BUILDING DEPAR MENT ID VILLA(;E OF RYE OOK JUL - 7 2023 938 KING STIMET RYE BRd NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT wi�Y,�V.ryopk.orQ INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date:_ AUG d 7023 Application Fee:$�7� �� Approval Signature; - Permit Fees:$ '/,6—WE Disapproved: Other: Application dated: ?— 7 t=a is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed state ut described below. el-_ _ 1. Job Address: 3� k9L: S •��'` - - Zone: 2. Proposed Improvement.(Describe in detail): C.(V�L RcpO A — 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No:-X� Yes: If yes,indicate: TIER 1: TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...):No:-X- _Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fain.,comm.,etc...)Prior to Construction: After Construction: 6. MY State Construction Classi cation: N.Y.State Use Classification: 7. Property Owner: L, C-1 Address: Phone# 91 ` 9 .L(.y? Cell# email��(j�I.4C4,:5�1l1I -(��, S. Applicant: Address: Phone# Cell# email: 9. Architect: — f ` Address: 652 G AMa.,G Phone# Z k Z �L3 k 9 -SFiL,2Cell# email:�I C�.�1�1d=R (�'d l cu�k 10. Engineer: Address: 1�1�1k-1�1F.�`�� (C�K 1 t CU i Phone# Cell# email: 11. Gen ,'eral Contractor: A61E -r LtR8Lr" Address: I Y�y b, Phone#-ne1 14• �' L4_ ✓ S I O Cell# email:' 1 LA(NS 12. Estimated cost of construction $ 3 O 1 000 I (NOTE:The estimated cost shall include all labor,material,scaffolding,rued equipment,professional fees,and material and labor which may be donated gratis.) //�� 13. Job Timetable: Start: 7 6�, A S t4' Finish: 3 I4 Q P 1 4A 5 (1) 6/l/2023 BUILDING 0EP iTMENT [E C E ME VILLAGE OF RYi.DROOK ID 938 KING STREET RYE BROOK,NY 10573 JUL - 7 2023 (914)9a9-0068 wryytryl �®gk,org VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF TEE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION. ANY BUILDING OR PLUMING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: A I oSu ,residing at, (.n c) a. t G !4 7✓5_—n C.P` p (Print natne) (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; VESTQ 4 L STLII_ QE?� (,I L, ,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. LrL. LL (Signature fPropertyOwner(s)) errs ,QL KALE f- 0(—' (Print Name of Property Owner(s)) Sworn to before me this Xf�.:'\ , 20' �1lSC�..�.c� (No Public) SRARI MEULLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County Commission Expires January 29,20 (2) 8/12/2021 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. Any application not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. Please note that application fees are non-refundable. STATE OF NEW YORK,COUtfrY OF WESTCHESTER ) as: — '\4(�l Ar�4_ ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the — erj t-7 N�7' _ for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attomey,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. By signing this application,the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property. Sworn to before me this Sworn to before me this day of L. , 20-;?- day fz 20 x 3 of Pro Owner APPu M7"'LiL operty Owner ante of Applicant Notary Public N° EiI MELILLO ,rl. 41 MELILLO Notary Public,State of New York ubl':,State of New York No.OIMES160063 .c. :,ME6160063 Qualified In Westchester County �,o in Westchester County, Commission Expires January 29,20 Z� i Frnfres lanuary 29,20{— 1 (4) 8/12/2021