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Home My WebLink AboutPP24-058 i a a x a c 00 s Ln C) N` \ a � s N N � ' L Q RJ1 --i x m w W � s ICI r,4 `n W � z i o II W W 010 : W A V z 4. 2 _ �2 a w oo �,, c!a z O a U en 0 a _ CC�� Hj t J en .µ 0 cJ) z a 10.0 A a WXO W = ►--1 CA a Cl) _ A � W zz � o �D z Q z o Ln� a' a I 00 A a w a 0 � DD BUILDING DEPARTMENT APR 2 4 2024 VILLA E Off' RYE BR' OK 938 KING;S ET RYE Btt(1O ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT 68 wwwbrook.org PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: Approval Date: ' rz7!�S\ Permit Fee: $ � Approval Signature: A— Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 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(767164111114h,0120011 that id Iu bing work will be in conformance with all applicable Federal,State,County and ILooccal Codes. I.Address: ( 67164/111 4h,,p SBL: / 3-6 /� 1'/�! / Zone 2.Proposed Work: 3.Property O r. P//R� -� Address: Phone#: V/7-6 Cell#1 email: 4.Master Plumber: Y (C! Address: f M Lic.#: /2% Phone#: 6 4/6 7! y� ell#: email: LJ 2 �'?Zj " < ,�c'►9 Company Name: /SrCAPorC-e- 'J^f45(?I Address: s , INDICATE FIXTURES& LINES TO EUNSTALLED 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 tst Floor 2nd Floor 3'd Floor 41'Floor 5's Floor Exterior 5.* List O r Equipment/Provide Details: zA Notarized Signatures Required Ne t 2 Pages) 3/3/2023 ZIC NEW YORK,COUN Y OF WESTCHESTER ) as: Mon V ,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 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 Pelbre }me this Sworn to before me this day of r 1 120 94 day of �-v ,20� Signature of P operty Owner Sign re of Applicant Print Name of Property Owner Print Name of Applicant 1 Et, 0 Notary ublic I-W$tate of New York REGORY M.RIVERA No.01ME6160063 Notary Public,State of New York Qualifled In Westchester County No.01�RI6441398 QOrnmission Expires January 29,20I Qualified In Westchester County C Expires ptember 16,2 This ica1on 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. 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 VIL ' 'E OF RY OOK 938 KING ET RYE BR ,NY 10573 4)939-0 w t ebrool or AFFIDAVIT OF COMPLIANCE VILLAGE CODE 4216 • 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: c.�R P ck. ;I) . Ct>,,j t , residing at, IPrint mine) (Address whcrc Nor iive) 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; Rye Brook,NY. (.lab 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. (-Wi (Signature ut'l'ruperty wner(s)) (Print Nanic ul'Property Owncr(s)) Sworn to before me this day of , 20 It t (Notary llvblic GREGORY M.RIVERA Notary Public,State of New York No.01 R16441398 -3- QuailfW In Westchester County Comrttisslon Expires September 26,204 811212021 QyE BRC��, 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 : to DATE: j Z �o Z i�Z PERMIT# [ Z �` ' Os A ISSUED: 4'ZS- ZySECT:I3 BLOCK: LOT: ( 7 LOCATION: r\P'j1 OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED FAILED /REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION n p ,8- Natural Gas ! U o ti GAS I" r I f ❑ L.P. Gas ❑ FUEL TANK rL2 PL C 'L.—> ❑ FIRE SPRINKLER 1J O C 6 l ? v 4-3 ❑ FINAL PLUMBING ` ❑ CROSS CONNECTION N - G G ❑ FINAL2xn i ❑ OTHER �yE BRcb, O� tim iV 1982 BUILDING DEPARTMENT ,❑BBUILDING INSPECTOR 9ASSISTANT 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' b V IN ! k3 / Aj VJ1O 0Q Ocr DATE: / ` / 2 O eel .110 PERMIT# 7 y r C S ISSUED: '1S 'ZXECT:/. S ,_W BLOCK: LOT: t J LOCATION: \->m P^�Q y� OCCUPANCY: ❑ Violation Noted THE WORK IS... ET-PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ,ET Natural Gas ❑ L.P. Gas ❑of FUEL TANK ❑ FIRE SPRINKLER ❑ "FINAL PLUMBING c ❑ CROSS CONNECTION FINAL ❑ OTHER * o cl a> co a� p M � * � •� w aJ 41 0 * U ¢+ cl co 00 * cC *k 0 uco Q Q Q v �9 d 9 cz A 'et * W co , as W 0�4 w v * .x t off$ u 7 Z A idlcnM * (, °"en O cb 4 � ;� VI ocd "r oo ? cz * 05 v v� E a o o ¢ � �