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HomeMy WebLinkAboutBP24-083 a pp ' T N = o (14 O N G: tu cn o Ln N-I Q 1 Q \ A o = Z O c �" E°. W 3 � � a� W © W >., ry 4-4Qr H o w 004 ° o t1 _ Z W onoen 0 Co Lo I!•� W x � ILn tn W Wog ° � .� ►`� W z A to AU N C�4 0 C 00 C o ° Py 11.0 F N z w CO A caq V C U tV ` H V z •D a c.. " a F•-I O M '� W I � � 0 � y W Rt cAi a ono a C7 CN tu \ U I—+ o a A A N 0 ' o v W z $ ao abvw cn lu am y a'a o C7 J2 c b.a A W z d ° � u . .. JJ � O W W � � a � � a BUIL WI DEPAR MENT U L� - I VIL OF RYE&LOOK [APR 2 5 2024 938 KING§Tfli EET RYE BROOK,NY 10573 _ (914)939-0668 I VILLAGE OF RYE BROOK www.rXebrook.org IBUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: n Approval Date: NAY 0 Q 7n Permit# � Application Fee:S /00 F� Approval Signature: Permit Fees:$ 00 _'`7 Disapproved: Other: Application dated: ""LA 2� Is h'crcby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the interior alteration of aA existing building,or for a change infuse,as per detailed statement described below. 1. Job Address: � 1 A 1 t~* R©itD' SBL:/,YJ► if—0 7 Zone: 2. Proposed Improvement.(Describe in detail): Jbx-411)YOOMS UPC64flU AQWhA I,A 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 II: 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) 5. Occupancy;(I fam.,2 fam,comm.,etc...)Prior to Construction: After Construction: 6. N.Y State Construction Classification: N.Y.State Use Classification: —7. Property Owner, dslbl,6 '�I Address: '^57 �dl( at JU Phone# _7 Cell# 9 �� .561 -6 410 email: to asm,, f �h+q tr0 A 8. Applicant: Address: ."14 h V " C a M Phone# Cell# email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: ,.or 11. General Contractor: rM +5 qemval G ddress: 2� S M iTW P-6 (_p I2 T L A+Ub T M q+IJD Fj NY )05 Phone# Cell# (g141 3 82 —IjG 2 email: AahCs ©L '6'i c*i0110 MC, r©1Y) �12. Estimated cost of construction 14'(3�0-0 A (NOTE:The estimated cost shall include all labor,mat I,scaff h%Cd cgw-pm`cnt,prof'ssionat tees,and material and labor which may be donated gratis.) ` gC 13. Job Timetable:Start: Finish: ban l c Y;of l o (,) CG 14-) ,' 8,Q — ]'2 6/1/2023 Coy'fraigccorz , BUILD � -—_,_ TMLNT ._.._ Q r; VJ r� VILLA E Oi"Ryli�OOK 938 KING STREET RYE BR6k,NY 10573 APR 2 5 2024 (914)939-0668 www.ryebro� Vlt_!_AAGF OF PVc RROOK _NT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDA`✓IT 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: I, Lots 6h 1;9 (dS IM,EPA ,residing at, '�__4 TAU C a tl I_f9 ad (Print manic) (Address where 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; 5 t( T a ( C 0 ff Q0 Gtd - , Rye Brook,NY. I(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. Lfw +11W (St-nature of Property Owner(s)) �D A--n o Ge) I d 5n4 l OA (Print Name ul'Property Owner(s)) Sworn to before me this SHARI MELILLO d Of , 20 `� Nc!ary Public,State of New York No.UME6160063 Cii�i1fied in Westchester Count (Notary Public) Expires January 29,20 (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 YORK,,CQUNTY�QF WESTCHESTER ) as: � ;� I' , 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 isAhe-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,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 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. s Sworn to before me this Sworn to before me this day of , 20 �� day of 20 CJZ 1 Cit Signature of Property Owner Signature of Applicant or Aft &d WGrh.A t Name of Property Owner Print Name of Applicant ty Public Notary Public SHARI MELILLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County Commission Expires January 29,20�/_7 (4) 8/12/2021