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Home My WebLink AboutPP24-016 a a e a A a 00 O V e h V � v h a W H W 00 W : en ONO Ln """' o v I-� a t en cncn Q a w00o W U44 ' LO coo, x 00 z w W ° O = CJ� z �n z o W � z _ 0-4 coo) G1 U A MMW z x f _ a n "" z pa x x oQ a to O o W a h d ►-� ;� 6 x �yE QRCv Q L� l� Q�1j BUIL MENT VIA. E OF RYE OK FEB - 2 2024 938 KIN , ET RYE B ,NY 10573 VILLAGE OF RYE BROOK or BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: C;)y'0 l0 Approval Date: fig 0,.k 7 Permit Fee: S Approval Signature: vu& Disapproved: v (fees are non-refundable) DO NOT START WORK or CO TRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A 111,1It1IIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUh1 FEE OF$750.00 Application dated, I- I -)-q 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: 3 3 4 8e+; grove RIA SBL: 13515 _f�3? Zone: 14 2.Proposed Work: Pke&we Sir 5'JR 3.Property O Q n 3� �Owner: ,� ; Address: w Phone#: 'f #. ��Upp ' 392 Cell#: email: RE► g 4 kn: (9 9,,4e►. 4.Master Plumber, h'L. Skier 1• Address: 5,4 S VAvt'17 Ay Lic.#: � 1`110110'#, q -)77-M I Cell#: 9/1/ --VO 4137 email: �.i�� . Skj�r 1, ,� rtSP• t Company Name: 9R rlt l:-17 Sp'r-'((S Address: 5), 5 INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: 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 3,d Floor 4'^Floor 5'"Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) L- 3/3/2023 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: /Z/C W,? ( ) I ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of indivTdAl 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 Z Sworn to before me this day o e ; ,20 6 day of e ,20 Signature of Property Owner Signatur ppiicant Print Name of Property Ow Print Name f Appli nt Notary Public Notary Pub Ic SCOTT J.GOWE R D �j NOTARY PUBLIC OF NEW YORK I.D./01G08357188 NOTARY PUBUC STATE OF NEW YORK MY com%S&ON EXPIRES��7�J� pUTNAM COUNTY This a1116.4 dy L t2 be4prop ly completed in its entirety and must include the notarized signature(s) of o t e 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- 10/30/2023 BUILD MENT - E LS C � V DD VIL OF RY OOK 938 KING ET RYE BR ,NY 10573 FEB — 2 2024 -0. - VILLAGE OF RYE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §2I6 • 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 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 WESTCHESTER ) as: 31, ® igd ;r�,�J, , residing at, (Print name) (Address w e 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; (J gy A, ' o`OV41 , 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. r (Signature of Property Owner(s)) *Now (Print Name of Property Owner(s)) Sworn to before me this Z day of `� , 20 'Z (Notary Public) RICHARD SMERLI NOTARY pU9L1C STATE O�N YflRK pUT:NAM COUN�'Y LIC. 1 1 'rt6�2. 40 GGMM, MIR 3 8/12/2021 QyE BRC�� 1982 BUILDING DEPARTMENT ❑BUILDING 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 : 3 3 (., P� - DATE: Z-(o -Z OZ / PERMIT# 1 ` 2--/ - c I ISSUED: Z-Z"L / SECT:1- .J• -) / BLOCK: LOT: �d LOCATION: 1RPEA ?Il0 P-eA� OCCUPANCY: ❑ Violation Noted THE WORK IS... "ASSED ❑ FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION , ` l ❑ Natural Gas 1J .� Ne(') e �n,J � C�, o\,O e M A\A J f ❑ L.P. Gas \� ❑ FUEL TANK _ ❑ FIRE SPRINKLER B-FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER � , i -� 1 �H� d x �.. �'� .;,�' N P t •��. a "�%w`>—� '•l( ti�a{' -A� - �� .,� .. c .. , �r ��, � _ J 4 _ 4, l;y :� .fit.�:.�d �*" .. ,.�_ _- .,.:- WE 41 Id1 1 `�`' !.'S op i. V Ira 11 Jv.& 1 r'