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BUIU" i
MENT D E C I E W E
VILROOK APR 3 0 2024
938 KINGNY 10573
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
Approval Date: SAY t e i Application# 0 4 +n -�
Approval Signature: : ARCHITECTURAL REVIEW
BOARD:
Disapproved: Date: /S.
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
Application Fee:'a� Permit Fees:
F?ENCE�/ WALL / GATE PERMIT APPLICATION
�Application dated: ' —J o��`7 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 or replacement of Pence,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.
1Y I. Job Address: 4 TA4-A"A� f` OLA
2. Occupancy/Use: I- Ill M S.B.L.#: 13 S" Sj.�-3-A ---Zone: ILq-
3. Proposed enc Wall/Gate(describe in detail): l
N UG ! ce S'r C M;k
ws y- 41�' et In '
4. Property owner: Lf T I l e r�d Pey n&,Kd o T�o sa kl
Address: LP$ 'T I MA V"Ac.Ir— Zo ao( l
Phone# °Ib4^a+-s-Uoy3 Cell# email: iiArOSA1-[S $3 ^ '.C*y►--,
Applicant: LeI1a C (2DSA_kS
Address: L 120
Phone# q 1 L4 d 1.rS-1DO 4 3 Cell# email: L-4-y03�a t� S 3__,- ,(,"'V1
Architect/Engineer:
Address:
Phone# Cell# email:
Contractor: 'I U ?(2k(, Fe-jqU, I i1(� I _
Address&Phone: Ll �1 Kl yv.11� � I*ILL 01 1 o g a
5. if building is located on a comer lot,which street does it front on:
6. What is the estimated cost of construction__ 1 gSOb
(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: S k M mtj— 2D 2-q
t
6N/2023
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 WESTCHESTER ) as:
ryV'ltr�n,,l +V s1d y ,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 thg le 1 owner of the property to which this application pertains, or that (s)he is the
�` 0 (e - W? 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.
Swom to before me this Sworn to before me this Z
/dayoff ,20 day of ,2
at Si ure of operty Owner i r of A ican
Femw iap k S�_uj {—G'']16ttAl of&b3
Print Naune of Property Owner Print Name of Applicant
Na Public Notary Pu b c Notary Public
LINDA A. SCHAFER LINDA A. SCHAF'ER
NOTARY PUBLIC NOTARY PUBLIC
My Commission Upires Sept.30,2026 My Commission Ftpirss Sept,30,2026
6A/2023