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HomeMy WebLinkAboutBP24-086 s s 00� N 4 w G7 w r' � Cti Q AN 14 Ln a a u, w�/ � �i O ag y � 0 cn FBI P3 � W `� CD w° c ° o� � ° O Mai zeno pQ O z A o � 3 � a-CD In u O p d' p a N O � ¢ -� � uan x O " � � a 5 co OR OZ F' W A �, U p p ob Z w z w zi -fj � -, p w � � 81. V W M W M cn 0 p � A en �., O o a a� ro U H F Fi.� NYC W V V �i � � zz b „ `� O C3 v T"� v a b e z W O A �► ono Off ° Iti 1.1 �1 z 0 ' V Z tz Cn A '� "j uo -f w O �" O H Gj °' w V x Ed OZ V G " V Eyo �° � N b O � ° N z E� W. v a a W z x Q 9 �I ¢, W �� BUILD! R` MENT VIL E OF R OOK MAY - 2 2024 938 KING ET RYE BR NY 10573 1 4 4 VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATIOIN FOR OFFICE USE ONLY: / ,�✓� Approval Date: MAY 2 24 r #:&Z) V-0&2Application Fee:$ / o Q Approval Signature: Permit Fees:$ 3 7d'�' Ue 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, - 1. Job Address: 61 N SSL:1 J 6 9 I"'�f�•� Zone: _ 2. Proposed Improvement,( escribe in detail):. 4 j • : a k 1 oa wk 105 A- A l `o i r ffi_ Lee. 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 I: TIER IT: 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: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 1 f 5. Occupancy; ,2 fam.,comm.,etc...)Prior to Construction: I Al/?,. After Construction: I i tt�,1in. 6. N.Y State Construction Classification: SA N.Y.State Use Classification: Q/- dw c,-w ' 7. Property Owner: �i4.,du_ �2Lt� Address:�Q �i 1/tu r ,1�, ,NY l©sF) Phone#__ )q-V37- 1� 4 Cell# email: 4r} S. Applicant: 6dwepcu>L sue-..,wit LSzc"s Address: f,,p ``pp�� 11 4 Phone# 2d kQ 4,,f'YO Cell# emait Orrin i fj r� l L �Ss.e ct�, 9. Architect: /1.4 W. 1�Yi*zs Address: Feti welcic &. or-ymk#, eT C%C// Phone# Cell# email: &�Y1 TCMFQ 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: /�tlii� ucr G .rx�/ Sk dress: to cc T 6 Phone# Cell p# email: r .r 12. Estimated cost of construction (NOTE:The estimated cost shalt include atl labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: (l) 6/l/2023 F�� DBUILDING DEPAR 1VIENT MAY - 2 2024 VILLAGE OF RYE. OOK 938 KING STREET RYE BR6' ,NY 10573 VILLAGE OF RYE oROOK (914)939-©6� �c BUILDING DEPARTMENT w .r ki.or - 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 Y O RK, COUNTY OF WESTCHESTER ) asE'+L : I, L i N D A N ��, ,residing at, s-; Lt� (Print name) (Addre�.N%�here NOU In t i 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; rlt e- Rye Brook,NY. 01- r 1ub:lddmss r 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 OwnerlslJ f Print Nan1C ul'Property Ownch,i) Sworn to before me this 'l day of , 20 ) Jackson Francis Henry Notary Public-Connecticut My Commission Expires February 28, 2029 (Notary Pul'h I (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 NEW Y%K,COUNTY OF WESTCHESTER ) as: ►..��*—=�t2� ,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 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. ttorney,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 2.17 Sworn to before me this -nA day of , 20 d 1 L ,2 Signature of Property Owner Signature of A lira �/Al 4 U Z Prin Name of Property Owner Print Name of Applicant Notary Public o ary Pubhc E Francis Henry Daniel Medina ublic-Connecticut Notary Public, State of Connecticut mission ExpiresMy Commission Expires ®ct.31,2026 uary 28, 2029 ,^ (4) 8 11 212 02 1