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BUTLD,.Tir[G�D'EPART MEN T NOV 17 2023 s
VIL NOE OF RYi,)3�R100K
938 KING STREET RYE BROIOK NY 10573 VILLAGE OF RYE 13ROOK
4)939-06�$j BUILDING DEPARTMENT
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DEMOLITION PERMIT APPLICATION
FOR OFFICE USE ONLY:
2023 ,b�'�3_00 Approval Date: a �' `� Application Fee:S )so_lbb
Approval Signature: Permit Fees:5 7 OCR— tJ
r
Disapproved: Other:
Application dated:It /S a 3 is hereby made to the Building Inspector of the Village of Brook,IVY,for the issuanoe of a Permit for the
interior alteration of an existing building,or for a change in use,as per detailed statement described below.
1. Job Address: 9 75 4010-RSoAv 1'116L W&D SBL: Zone: pub
2. Proposed Demolition.(Describe in detail): /N7Z'?/0? (±✓VN- S T RNCTORh 91 0'Fd7o&tr/e"'/ 0 /-
C OW 9 C rY It, P F/21 r? 0 W G PL,, V a 7r4 r3 v/i O,N� III 1,-7F t01VC,r J9 4eic IPM-u- A%W
p o oP IWOU d to 1' z!2 /h=rF� S 7ts CW
3. Property Owner: C,/�C,�e /CAOQ f�f Addre- r],:5-C-) .4�ex/,7�//)AV e N y A) 7
Phone#c��o1�a.3��1�D� Cell# email;
Applicant:TW C/AvieG'✓//ter, CAP✓TOO r?07 rWC_ Address: 5. SSA- /'Ne[ P P-"T 1,,d 0
Phone# f/V- 9�3~ZDoO Cell# (0Y-7,77-tP7i¢/ email:yo�� GAO'/ &✓r��C�/aG, Cv�"t
Architect/Engineer: Address:
Phone# Cell# email:
(W-71 ttoftj>Nt, c ✓yt
General Contractor:o era r,4PjTif+- /NOtrs Y2td S Cerc R Address;s *55 _Wtv r^i✓it ({7j k Ro(• }roy, 17 61
Phone# 9IY- 963-'Z0190 Ce1l#Wy- 722- °r}7u email:i 4p/F6`4 prMypa G'ppirrn_
w2�Cca�yL, (�or"1
d, Estimated cost of construction $ 3 6 D, &00 , &D
(NOTE:The estiuuted cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated
gratis.)
5. Type of construction:(wood frame,masonry,steel,etc...) f>�=L''r2��' , %►�7r+� S tin gf Jim ,C e/b1,1 0,.2f
6. Method(s)of Demolition: "-/P,k 5' rp S ZGr�p,
7. Number 8c Location of Fuel Oil Tanks to/be Removed:
S. Number of Stories:/'1 _ Height to Highest Ridge: y To Highest Chimney:
9. Estimated date of completion: Fire orai i ea}' 0 0s y
t
6Il/2423
This application rnust be in ilKs entirety and must include Uic 110"LarNled
SignaUll-O(S) Of 161(' 10g@1 Olffler(s) Of the Subject prope;�tiy, ani-I die ;ippflc:FrjL o-1:-Fozrord in t"he
spaces provided. Any applica-11on not proporly conlple'?Od in Ra ent1r0-iyand/0:i- 110-i prop01.1%sigme-ci shaill be doome-cl ar.-d void and -mfll he i-eturned to the applican-l'.
Plea,sa note that, application Mas eql'e- nOn-Vef-undable.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
, 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 legal owner of the property to which this application pertains, or that (s)he is the
for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent,attorney,vc)
That all statements contained herein are tnie to the best of his/her knowledge and belief,and that any work perfornied,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 Ullifor-M 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
Swum to before me this
Aj,vt4v, 20 ZY
day of 20 ,-23 day of
Signatur fPrc)pDrTy caner Signatur—
ppfi ant
Print Name or Applicant
""Pe"y Owner X-'yP cl'. Notary Public
MADELINE C. CITRONE
Notary Public, e Stat of New York qlCHARD TOCCO
L �7 w,ary Public-5tate of New York
No.01 MA6030446 NO,OiT00005122
Qualified in Westchester County Qualitled in Westchester County
Commission Expires Sept. 13,20 My Commission Expires Apr 4,2027
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