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HomeMy WebLinkAboutBP24-047 x : w y a N \ � W CV N M � � y t/A cnj W C� 1 0 0-0 ., ca ILI cl y F+i © O Q r l O 1v C g y w Q o o pQ � ocw ° � � A = V a. v W v 8s -9Vo C/ 0 in Q W o o a'm u o Q o ° v Od W O (� r� z w c �I z A Wv � + O C — O � � ,7 F-�� V cn ►may -� o Z O ai a z w , Q � � � - W w enw 7 1 � 0 U M C] Q ° W o C rgU Q p H W � " � ° - 00 H 1 V � � `� O V a z o �Avo 's � a H ° ' V w ti W '� ff �' ,� ' o � o o „ W O gg. d a� k � Cl) e v u -21 U w O Hoc ° - U x v © v Z y, O V g � � ;� —. v w o ° 0 '�' A � O a v� �- a'ai o W W �"A O >" �a ' • D BUICETW(E TMENT VILROOK DEC 15 2023 DD 938 KINGOK,NY 10573 VILLAGE OE RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: "/0 �,1� f'�l�Approval Date: +2. 4 rmit# / — / Application Fee:$ /�00— Approval Signature: Permit Fees:$ 1 ' Disapproved: Other: Application dated// ` �' 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 statement described below. Q 1. Job Address: 0ty1 00p+'1i I I�!t'V SBL:/� /�COS-I� Zone: /�-�� 2. Proposed Improvement.(Describe in detail): iLa LAC4DM I A) k-s'XQ 9&fld9JrM AnA2 21_s -T-; h 1J -fly SEA5hy FLp-avz c21c v`�1 t�51 C IrGtl lj 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes: If yes,indicate: TIER 1: TIER 11: 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: Yes: (Ifyes,please submit a separate Automatic Fire Suppression System Permit application& 2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: After Construction: 0. NX State Construction Classification: N.Y.State Use Classification:7. Property Owner: Qr i�i r� / d r ss: v�r /,+ ©at� / Phone# &V) 9,3 f-I.? Cell# gl d 7� email: C©/0 711 T' � 8. Applicant: Address: Phone# Cell# email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. G gnat Contractor`f�' IQ 4 ee-�c VCL-Wo 1_5 rf i .ea) Prej Phone 4- II# email: � � -3� 7 21- 12. Estimated cost of construction $ ��� �d 0(NOTE:The The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which maybe donated gratis.) 13. Job Timetable: Start: Finish: (I) 6/1/2023 nOFRy D BUIMENT VILOOK DEC 15 2023 938 Kiwi ,NY 10573 VILLAGE OF RYE BROOK www.ryebro`ok.org _ BUILDING DEPARTMENT 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 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 O`,F�WESTCHESTER ) as: I, /�i 6r,-14 . ���5 �ti�i� (0'0 ,— 'residing at, Rlh ©�J/L*�/ �DQ✓�- / (Print name} (Address where you live) YC 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 �r✓�i i��ppp�G�J/ /� �O ,� G �3rd0,k , 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. (Signature of Property Owner(s)) yp-S /v . (Print Name oCProperty U%tincr(s)) Sworn to before me this_� ' TAYLOR CONNOR EMANUEL day of 1Yl 20_ NOTARY PUBLIC.STATE OF NEW YORK Registration No. 01 EM6436546 Qualified in Westchester County (Not P i'li` My Commission Expires July 18, 2026 (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 N�W YORK,CO,�JhjTY gF.WESTCHESTER ) as: I'/Q f+ DS flV� (mac' �Qf'7j , being duly sworn,deposes and states that he/she is the applicant above named, (print name of in"idual ning 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,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 I.-IIIIA Sworn to before me this (lat day of'D?iI?J Yn1ne I'- , 20 .0�2 �J day off s IfY1 A'r , 20 � /047 Signature of Property Owner Signature of Appl icannnt ,rt,,l dK1d__ /o� I OS ri N'C7 , �i r/� Lo% 7 Do i Print Name of Property Owner Print Name of Applic /v No r ub is N7 Publi TAYLOR CONDOR EMANUEL TAYLOR CONNOR EMANUEL NOTARY PUBLIC.STATE OF NEW YORK NOTARY PUBLIC.STATE OF NEW YORK Registration No. 01 EM6436546 Registration No. 01 EM6436546 Qualified in Westchester County Qualified in Westchester County My Commission Expires July 18, 2026 My Commission Expires July 18,2026 (4) 8/12/2021