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BUILDING DEPARTMENT F C r � v
VILLAGE OF RYE BROOK H APR - 2 2024
938 KING STUEET RYE BRoox,NY 10573
(9._14 9-0658 VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
��Approval Date:APR 2 2 2U Pe m Application# pa2q "(1_" 0�/�
Approval Signature: ARCHITECTURAL REVIEW
BOARD:
Disapproved; Date:
BOT Approval Date: Case# : Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other 1 r
Application Fee: Q Permit Fees: �/c)�o �UC
FENCE I WALL / GATE PERMIT APPLICATION
Application dated: _ZQ is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit
for the installation,construction,repair o replacement of a Fence.Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code of the Village of
Rye Brook,as per detailed statement described below. Swimming,pool fences must conform to the State Code.
1. Job Address: Z, J4.,eM -Gy L4 N, V-j"k?Yd c G I 1 N) t osa 3
2. Occupancy/Use: S.B.L.#: l Zone: r,
3. Proposed Fence/Wall/Gate(describe in detail):
E 1v, l�l c.at
4. Prope Owner: _ pp
Address: I- -4v VA vwz Irp
Phone# Cell# �, L4 0W email: II'1,S G 1. bo 4M
Applicant: 1,M�
Address:
Phone# Cell# email:
Architect/Engineer:
Address:
Phone# Cell# email:
Contractor: IDAU IY (M <9lV Lk 1YKMtA Uub
Address&Phone: -4 VULkit4 ILA) �A- (� - R)- -
5. If building is located on a corner lot,which street does it front on: �diV1V111 �A VU_
6. What is the estimated cost of construction Lt,V
(NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment•professional fees.and
material and labor which may be donated gratis.)
7. Estimated date of completion: 18Sr1 Mow
Please note that this application must include the notarized signature(s) of the legal owner(s)
of the above-mentioned property, in the space provided below. Any application not bearing
the legal property owner's notarized signature(s) shall be deemed null and void, and will be
returned to the applicant.
STATE OF NEW YORK, COUNTY OF WESTC14ESTER
being duly sworn,deposes and states that he/she is the applicant above named,
(print n of individual si ng as l;applicant)
and t er states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
A {m L )1( for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,agent,attorney.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 Rve Brook and all other applicable laws,ordinances and regulations.
Sworn to before me this 9 Sworn to before me this
day of (1\ , 20 day of k , 24
4 . � �Q
Signature ol Property 4 r Signs re of plicant
t ame of operty Mrier j P7trej)f Applicant
Nota blic Notary Public
SHARI MELILLO SHARI MELILLO
Notary Public,state of New York Notary Public,State of New York
No.OIME6160063 No,OIME6160063
Qualified In Westchester County. Qualified in Westchester County
Commission Expires January 29,201� Commission Fxplres January 29,20��
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