Loading...
HomeMy WebLinkAboutMP24-007 a a _o o v � rn U m v o � 0 F� O ` ai O w s°3 0 v V� © H A _ W z �, ° � c . o b p a v o 0 • O L p ° Is, Ln a 1 in O W W Ocaw a, w Z �3 z z „ Q 00 clztWn c� o Ca pq oc a H O aW z W cn C d LE 0 5 -o rs, w O Cn r z z ro o V a O O0.4 ix [� a H �i Q ✓ U z 0 Q P..y v � s v o W . O O v a U , z 3 o co m oI p U o V a0, 1 § ; � U x . e w i o a �--� A W Z H ° d 5 0 ^O U U W � a� a v w 0 � � BUILDING ISEPA R�TMENT JAN 10 2024 D) VILt��ttCE OF RYE�`OOK 938 KIN STREET RYE BR00 NY 10573 I VILLAGE OF RYE BROOK (914)939-0668 FAX(914): 39-5801 l B111L171NG I�EPAR i MENT ww"v:rvebrook.org APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: Approval Date: 1 14—7.102. Permit Fee:$ Approval Signature: ,P.- Other: Disapproved: (fees are non-refundable) RE UIREMENTS FOR RELEASE OF PF,RMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance.(Village ol'Rye Brook must tx:listed as certilic:ue holder)&Workers Compensation Insurance on a NYS Board form(Form#C 105.2 or Form#1J26.31 or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit:RESIDENTIAL=$I00.00/unit•COMMERCIAL=$350.00/unit. 5. Inspection by the Building Department for removal and/or installation.(48 hour notice required 6. Electrical work requires a separate Electrical Permit&Electrical Inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. Application dated, 1110/2024 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State,&Federal laws,codes,rules and regulations. I. Address: 134 Brush Hollow Crescent SBL: 129.76-1-126 zone: Pub 2. Property Owner: Bryan Wexler Address: same Phone#: 516-528-8245 Cell#: email: Robison Oil One Gateway Plaza, Floor 3. Contractor: Address: Port Chester, NY 10573 Phone#: 914-847-0295 Cell#: email: iweir@robisonoil.com 4. Applicant: Same as above Address: Phone#: Cell#: email: 5. Scope of Work:New Installation( )•Replacement(X)•Removal( )•Other( ): 6. List Equipment: Replacement of oil boiler, 7. Location of Equipment: Outdoor Utility Shed. 8. Method of Installation/Removal(list oil equipment needed to perform job): Removal of existing boiler and install new Energy Kinetics EK-1 oil fired boiler. t 6/1/1 B STA FF 01:NEW YORK,COUNTY 01 WESTC1 LESTER ) as: Jean weir being duly sworn,deposes and states that he/she is the applicant above named, Orvlt name of tndrvidual 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 Contractor for the legal owner and is duly authorized to make and file this application. (indicate architect,contraetnr,�,enl,attornty,etc) That all statements contained herein arc 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 Ryc firook and all other applicable laws,ordinances and regulations. r �r Sworn to before me this- Sworn to bcfo e me this r/ day of jl.n `` 20 �I day of �I 20 /Si natu vfPropelny1vOs[vner /_ f_� S'mature LoffApplicant U� 1�� �✓�k��� / Jean Weir Print yme of Property Owns Prii-n-1 anlc- fAp I- t Nolan Public arnanda K olm. -1)ry Pu hi CAROL ANN PRIORS NOTARY PUBLIC,STATE UP NIiW YUR Notary Public Registration No.01OL6417632 Connecticut Qualified in WFSTCIIFSTF.R C my My ComRnttlon Expires May 31,2025 Commission t'xplr21 OVR 025 This application must be properly completed in its entirety and must include the notarized sionature(s)of the legal o%vner(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 Yaill fx returned to the applicant. 2 Wills