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HomeMy WebLinkAboutSP23-003 _ F 4 � F ■ � N O _ rwq� s G N M M ' W\ tdn in V3 a c u k ° C/) A AG °� e ° CA no Q C � 41U Z `n L.� o W cq Zo � b [�] � u u C !-1 �1 /� �► CO Z t- ,A QQ O � (�O � � � a~i � 1�1 V10,00 � Q O '� � � n'�.. Q■1 pWo V Cr o q (1Z � � oc �70' V) V! U U r W 3 < p � � a � O m a z � � d � w > ° -EggQ V oo Sri L 0-4 rn cy .e VS r�hho� a Z z O V O z 0 z F l Q V g � z , op � F p z q aid 20 o w9m U7 U z N C7 A z O n rA N � b Z AG W H U,< a W z `� 9E a 0a ~WW �� � c. 3 0 R' a_ BuIi.D D% ARTMENTvM 938 KING > A _ . NY 10573 MAY 16 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION FoR EXTERIOR WORK WHICH DOES NOT REQUIRE VH LACE ARCHITECTURAL REVIEW BOARD APPROVAL FOR OFFICE USE ONLY: APPROVAL.DATE: �3 APPUCAnoN Fwjc APPROVAL,SIGNATURE: PERMIT FEES: S 3 c_�OS 6 0 H.O.A.APPROVAL: DATE: DISAPPROVED: OTHER: Application daoed y Cre' is hereby made to the Building Inspector of the.Village of Rye Brooks,NY,for the issuance of a Permit for the construction of buildings,stmettaes,addmon$ d% ations or for a cbange in use,as per detailed statement described below. 1. JobAddress:-) �Z- 5- 41 b&"' yF--r'y i 2. ParcelID#: I — loZone: 3. Proposed Improvomon Meombe in dotal): A G + /1 r 4. Property Owner: c Address:_ Z+ /T-r Kr-LA P/—AtA Phone# IE&I— 7V` 6t&2 Cell# e-mail List All Odler Properties Owned in Rye Brook. Applrca=_J©AJ Address: Phone# Cell# o-mad 12s✓r Architect: Address: Phone# Cell# e.-mail Engineer: Address: Phone# Cell# o-tnail General Contraetnr r� Address: ! A' IfQ /,l e Phone# — ll# o-mail (L) ti/l7lltldl 5. Occupancy;(l-Fam_,2-Faro.,Commercial.,etc...)Pre-construction: Post-construction: 6. Area of lot: Square feet: Acres: 7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: right side yard: __ left side yard: other:. 8. If building is located on a corner lot,which street does it front on: 9. Area of proposed building in square feet: Basement: I"fl: 2°d fl: Yd fl: 10. Total Square Footage of the proposed new construction: 11. For additions,total square footage added:Basement: 1"fl: 20d fl: 3'd fl: 12, Total Square Footage of the proposed renovation to the existing structure: 13. N.Y,State Construction Classification: N.Y.State Use Classification: 14. Construction Type&Location: ()Typical Western Lumber France;()Timber Frame[TC];()Wood Truss[Tfl; ()Pre-engineered wood[PW];Located;{}Floor Framing[F];()Roof Framing[R];()Floor&hoof Framing[FR];Other: 15. Number of stories: Overall Height: Median Height: 16. Basement to be full,or partial: finished or>mflnidw& 17. What material is the exterior finish: 18. Roof style;peaked,hip,mansard,shed,etc: Rot►Sag mderisk 19. What system of heating: 20. If privatc sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 21. 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...)Yes:_No:_ (f yes,applicant mast submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes:_No:_Area: 23. Will the proposed project require a Site Plea Review by the Village Planning Board as per§209 of Village Cade? Yes: No: (if yes,applicant must submit a Site Plan Application, &provide detailed drawinV) 24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (if)es,you must submit a Site Plan Application,&provide a detailed topographical survey) 25. Is the lot located within 100&of a Wetland as per§245 of Village Code? Yes:�No:_ (if yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes:—No: ('dyes the area and elevations oftheflood plane must be properly depicted on the survey&site plan) 27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: (yfyes,applicant nmst submit a Tree Removal Permit Application) 28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No:_ Indicate.TIER I:—TIER II:—'PIER III:— (Ifyes,a Home Occupation Permit Application is required) 29. What is the total estimated cost of construction: $ Note:estimated cost shall include all Me improvements,labor,material,scaffolding feed equip�mba,professional fees,including any material and labor which may be donated gratis,ffthe final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO. 30. Estimated date of completion: (2) 91122R21 BUILDING DEPARTMENT OOK 938 xt c:S - NY 10573 ►► rc►r�k.o 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 PLUMING 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; t`SL�S ,residing at, 2 - (-yi- (Print name) (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; 5 S i z��� ,Rye Brook,NY. (Job Addr-: 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. (AiGUAkA of Pr" ©wttr(s)) tW T— wA1 ,k 9 + Il U4ci NW 5 _ (Print Name of Property CYWFF�s)) Sworn to before me this day of 20 2.3 (Na bGc) JY CpM!"?! ER t`Jntary P!;;. 'c r,' 'N'r-wV Ynrk Cctrlmis•'torl F_xplies Mach 9, '.311 8/12ln021 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer& signed by those professionals where indicated. It must also 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. !xx!!!x!!!!!!xlxxxax!!x!!!!#x#lxxxxx:#!!!!!!!!!x##trlxxxlxlxl+rxxllt:##txxxxwxlxxx!!t#x#t##!*xxxxxxxlxlxlt! STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: J CN PEEHAki j&J P being duly sworn,deposes and states that he/she is the applicant above named, (print name of in&vidaal signing aE the wpheant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the 13LU',l 0oii'J- Z for the legal owner and is duly authorized to make and file this application. (iamcm wchitwt contractor,agent,atwwy,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 5 Sworn to before me this day of , 20 Z day o 20 S' of Gweer Si ure of GIyL--L4 5HSWk1l4kd a Print Name of Property Omwr j Print Name of Applicant A_ .4 Notary Nbfic Notary Public w t 1v rf -7 i ' rC 800TT W.CRAIG Motery Pubic of i kw York '} REG NO. 01 CR6390567 1 b GOM OSSION EXPIRES 0411W"27 (4) 6N'IMRI