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HomeMy WebLinkAboutPP24-104 s s = a z O p � aJ E z 1 N _ \ t '" s cq a a a a u x pR w let w , z \Q w� 010 a' p � Ra F" � O x O � O ►n Lo 14 W U P� w 00 �"� w �,z O W 1%0O �n H o a -- z c w a@ s �C a ►� wA x w x U0 w � o x BUILDING DEPARTMENT I VILi,AcF OF RYA: BROOK FrJUL 938 KING, STRFFT RYF-BROOK,NY 10573 VILLAGE OF RYE BROOK (91 )939-0661; BUILDING DEPARTMENT www.rvehrookny.gov --- _ ------.-- PLUMBING PERMIT APPLICATION FOR OFFICE USE (s ,,1.Y BP#: PP#: / ld I Approval Date: — 7 S— z o Z H Permit Fee: $ Q Q©_/""._� Approval Signature: . C� L-� Disapproved: (fees are non-refundable) DO NUT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDNNC: INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED M iTIIOUT ,4 VERNIH IS 1�2%OF THE TOTAL COST OF CONSTRUCTION' 1i ITH A MINIMUM Fl f t.)l�S750.00 Application dated, �i —3`c / is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuancc of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agreet that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: 1 + Q �A►R 9, SBL: y.l?��- _Zone: 104 2.Proposed Work: > r;Nl: ia VA 0, -- 3.Property Owner:;,,4j 'V \6,kXkL SMAIMAn.J Address: b L) 6_111. Fg1r— y1a — ------- Phone#: Cell#: WD — SOS 96'14 email: Ro QA , il-1 LCiwy_ - 4.Master Plumber: C V ek C M Address: 4 Mg Fr,NN►_1i,j Lie.#: Phone#: 114-30 -ypo a Cell#: 1I m-I-1C10-'j3,i5 email: (IAj O Company NameW\ ?juA;,jn-1' k4i% NZ Address:,41I FttyKli�+ S�' oak Ctw!C� n/ , INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: r s��3 Loeadun Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural, Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP as 9asement I st Floor `_'nd Floor —� 31i Floor 4"'Flour j EXteriol �7JQ I � 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages; -1- t, , -(,_: 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 Master Plumber for the legal owner and is duly authorized to make and file this application. 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 ( H— Sworn to before me this day of ✓� 20 day of Signature of Property Owner Signature of Applicant Print Name of Property Owner Print Name of Applicant IJ <t t u h I i c t &Wq u c, tate of New York OLENA TATURA No.OIME6160063 Notary Public,state or New York Quallfled in Westchester County No 01TA6346956 Commisslon Expires January 29,20 �Qualified in Queens County Commission Expves August 22,20 vi This application must be properly c ipleted 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. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/l/2024 BUILDING DEPARTMENT R v " VILLAGE OF RYE OOK 938 DING�*REET RYE BRO NY 10573 JUL 3 ( 14)_ �-Ob68 w _"' ov VILLAGE OF RYE BROOK BUILDING_DEPARTMENT k::k:;•�••k k•k 1:':•k•k•k�kA••k•kkk:F�:YA••k kaF ti****9e:F9e•kie•k it k�e•k t et a�•kaF:Fdr*•k•A 9r at dr WeF drkek il•rN•k9:*#•ir�r it 9:k9e ir+Y•k F dr it**ak•k*ie•kaF*ie aF*ie dr•k•k f'r**:F**d••k* 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 YORK, COUNTY OF WESTCHESTER ) as: - Mir 3, '_bOb GYY1nti' , residing at, y c��LFg;t� � Ryt �xcx�: Mi (Ad di 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, Niy- - BS'13 , Rye Brook, NY. I lob !kddre;cj "I 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. 5 � 6l':uat \;uur � 4" ni� i) i_tti�nEaIsMl Sworn to before me this 1 day of J4 1 120 OLE NA TATIJRA RpW y Public.State of NewY0ft No.OI TA6346956 QualNied in Queens County Cwrnission Expires August 22,20__ 6/1/2024 �yE BRC��• 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR [ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS :- b -1 -6r L L e 1G �. p'-)-,- DATE: Z O Z PERMIT# ? ? N- /i q ISSUED: -S - 2 `' SECT: BLOCK: LOT: LOCATION: ( `�'--/*\ >)C L L OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ^� ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER