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HomeMy WebLinkAboutMP24-062 e f f ■ N m N c ~� � N � a h�l � W3cl 2 ►Ln Ln ° N ® � W CA Q" a a W A F�j CA W Ccn A 00 a � w = � z W 4 n Q o O F+q m v fr--1 F•51 0 W z p C C aen' e m LO W oo ON A17 0 8 � 1+1 Q O W vz -;" a' t Z � 11 ICNM M c7 `n ° d0 00 A" UN 00 H M �T� \/ w v �i ►7 0 c!� a�v o q m O j 0(n w w A u � 0-40 o Z a --w Q ~ n o . v (Uq c0� si x ~ Cl) Gi,, Ri V �'' O a�i v U _ w p o O E. z FCDp m a !�1 ~ az � � � p U (} w 7 ri 0 a - m 2 a c � � 1/ BUILDING DEPARTMENT L VILLAGE OF RYE I r�oOK MAX 14 2024 938 KING VILLAGE RYE BR©oK,NY 10573 (914)939-0668 91 39-5801 VILLAGE OF RYE BROOK ww. o .ore BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING E�Q/UIPM/ENTT FOR OFFICE USE ONLY: PERMIT#: 2 Approval Date: Permit Fee:$ Approval Signature: Other: — Disapproved: (fees are non-refundable) REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: I. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance.(village or Rye Brook must be listed as certificate holder)&Workers Compensation Insurance on a NYS Board form(Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL=$100.00/unit•COMMERCIAL=$350.00/unit. 5. Inspection by the Building Department for removal and/or installation.(48 hour notice required 6. Electrical work requires a separate Electrical Permit&Electrical Inspection. 7. Plumbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. Application dated, 513/2024 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws,codes,rules and regulations. I. Address: 132 Brush Hollow Crescent, Rye Brook, NY 10573 SBL: 129.76-1-128 Zone: 2. Property Owner: Adena Mann Address: Same Phone#: 917-683-8305 Cell#: email: adenamann aQgmail,eom Robison Oil One Gateway Plaza, Floor 3. Contractor: Address: Port Chester, NY 10573 Phone#: 914-847-0295 Cell#: email: iweir@robsonoil.com 4. Applicant: Same as above Address: Phone#: Cell#: email: 5. Scope of Work:New Installation( )•Replacement(X)•Removal( )•Other( ): 6. List Equipment: Replacement of condenser and air handler. Install new Bosch heat pump condenser and Bosch air handler. 7. Location of Equipment: Outdoor condenser and attic air handler. 8. Method of Installation/Removal(list all equipment needed to perform job): t 611118 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Jean Weir ,being duly sworn,deposes and states that he/she is the applicant above named, (print name or 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 Contractor for the legal owner and is duly authorized to make and file this application. (xuJtcate architect,contractor,agent,anorney 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 ofthe Village of Rye Brook and alt other applicable laws,ordinances and regulations. Sworn to before me this 7 G Sworn to before me this day of�-L L ,20_n day of 0 Signature 'P perry Owner Sign Applicant 7 CA ✓1 C.t q ki lei an Weir Print Name. Property_0 r rint Name of Applicant Notary Public Notary Public tNDA A.ROGGIERO NOTARY'PUBLIC,STATE OF NEW YORK Registration No.OIR06026828 CK41hfied in Westchester County Commission E ms June 21.20 V 7 This application must be properly camp zed 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. z � I-is