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BUILDLPARTMENT
VILLA OF RYE BROOK MAY - 1 202�
938 KING STREET RYE BROOK,NY 10573
(IR14)939-0668 VILLAGE OF RYE BROOK
www.rVebro4&orL BUILDING DEPARTMENT
FOR OFFICE USE ONLY: /� �(� '3/ /� /
Approval Date: MAY 2 1 Permit N^ / (� Application# AR,B04 o50
Approval Signature: Y A RCHITECTURAL REVIEW
BOARD:
Disapproved: Date: a
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
ZBA Approval Date: Case#
Other:
Application Feel — Permit Fees: '
FENCE / WALL / GATE PERMIT APPLICATION
Application dated: �/—ci is hereby made to the Building Inspectorofthe Village of Rye Brook,NY,for the issuance of a Permit
for the installation,construction,repair or replacement of Fence,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.
1. Job Address: 1. 1D "` g— yt7'Swza
2. Occupancy/Use: S►Y1F & S,B.L.#: , 7& Zone: --/
3. Proposed Fence/Wall/Gate(describe in detail):
wwrL PVC Pnow lit 'F
4. Property Owner: it-
Address: � 00 b
Phone# Cell# 201 -72S Ij2Ljfj email: whd1 b it P( fVtCt1 .cW
Applicant: MU ruyl Di i r
Address: 1 QUCcL►cAtr Of _ �G BrocxK Wq _135:f I:o
Phone# Cell# 20l Z5 Aci ate email: 1'y/lt aAb 1 r oI qMa'%I,rom
Architect/Engineer:
Address:
Phone# Cell# email:
Contractor: j
Address&Phone:7 a � �/Q/ 14 y /Q-]/d
5. If building is located on a corner lot,which street does it front on:
6. What is the estimated cost of construction $ (D .Q'1J 0,Cj d
(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: Jun-L 2.0-L4
6/1/2023
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:
,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,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.
Sworn to before me this Sworn to before me this
day of Q , 20 day of 0-" , 20 7 A
13
Signature of operty Owner Signature of Applicant
( i -fn 1„i 'Dv y(' SHARI MELILLO oV) DU I r'
P Name of Property Own
I`'�� Notary Public,State of New York Pri a of Applicant
' No.01ME6160063
Qualified in Westchester County
Commission Expires January 29,20
Notary Public Notary Public
2
6/1/2023