The URL can be used to link to this page

Home My WebLink AboutBP24-033 ■ ■ a � � � n ti p ■ O _ \ 00 ^ , r- \ ll-` ti n x rZ Q 94 O = w z Q r-� �. a peT c i3. v 0-4 P4i a0 by tf) Z a OA m v z 8 o �J p : V y W �. s MM W W. M M � � z W w Cn 0 � u w en en AW a en en00 Q 'Ap 0 C 0 F. a v _ Q W W O v ° C) v w O 1-4 w c CIS 00 _ z Q W z �U:) 51, o Q z o S a ti v r�i ■ o 5 o ? � •� � � w oG O U o o v0-4 v U W H O z a v4 - 0 0 <R w a N 4,� a V Q V U Z i R o ■ a, cn a ■ O C � C7 A o oOCC o DO lu� IDBiJiLD _&kRTMENT FEB Z B 202 ViL E OF R OOK 938 KING ET RYF BR ,NY 10573 VILLAGE OF RYE BROOK .?l4) 0 $ BUILDING DEPARTMENT W'Ww.-ry 0 l dr INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: MAR 0 #: �� _<�-Application Fee:$ Approval Signature: Permit Fees: S ,s(0 V - Disapproved: Other: {` 5- cap -21 CO fc> Application dated: 2` 8 is hereby made to the Building Inspector of the Village of Rye Brook,NY,[oi a tssuatike of Permit for the interior alteration of an existing 6uilding,or for a change in use,as per detailed statement described below. 1. Job Address: A L oy ca L c o C¢.e o g 1 VE. SBL: I35,(a(,-1-4 k3Zone: 2. Proposed Improvement.(Describe in detail): V e 1-^\/6L OF w Q L(r 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 I: TIER IT: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire suppression system(Firs:Sprinkler, ANSL System,FM-200 System.Type I Flood,etc...) :No:�_Yes (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(I fain.,2 fam.,comm.,etc...)Prior to Construction: 3 f k)&L.l% FA OAfter Construction: S I W61LC F-A,M IL-1 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: MZ, EVJNQ TA► POK Address: 1L OU& >L.E 06aG PILIVE Phone# C1 14 3Z �y��I Cell# email: 8. Applicant: L y L to O t Le-0 Address: -S(! F(F I u W E Phone tt q(4 -243-6643 Cell# Q14-4&c)--914J email: L Uc. ,o(P S T00i O2 CON1 9. Architect: L oc1J Qt I &0 Address: 50 FI_F-7A LTV e - 106LI-1AM'-1 Phone#q14-243 -(,B43 cell # 9 14- �60 -944O email: Lvc-lo d S 7c)01012 N1 , CL)V1 10. Engineer: Address: Phone# Cell# email: A T 11. General ContractorAL G.ylt rfdv(S �L Address: Phone#.)U3`a)q3--06 3.S Cell# �O3-, y� - oC 3 S •ema' ILv gl�..GcY1'1 G7 12. Estimated cost of construction $ 17/0 v U -1 5'I too 2+ to O (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and matenal and labor which may be donated gratis.) I `/ 13. Job Timetable: Start: 3 / Ld_T Finish: (t) wlnox3 p ECEN BUILD, TMENT FEB 2 8 2024 :3D V1L E OF R OOK 93$KtIvG �FT RYIE BR O�iC,NY 10573 VILLAGE OF RYE BROOK -0 BUILDING DEPARTMENT 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: I, �U N 0 residing at, 14- LO iV(A L I_D Ca_C-- V QA /L iPnn[nanie) kAddiess where you Irvei 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; 4- L 00 a l,O-Dze e NJ U , Rye Brook, NY_ 0ob.add[ess) 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_ &V No Sworn to before me this a4n.dt KAREN BURLEIGH day of ,�Z (e , 20 NOTARY PUBLIC,STATE OF NEW PORK Registration No.01 BU6250965 Qualified in Westchester Canty Commission Expnft 11/14nO27 (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 ^y �`NE �N,N at,�Y OF WESTCHESTER } as: 1 ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and rther states that (s)he is the e,$aI owner of the property to which this application pertains, or that (s)he is the PK0P6RT y d LJ G R for the legal owner and is duly authorized to make and file this application. (indicate architect,co tractor,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. Sworn to before me this a O Sworn to before me this day of 2 , 20s '�,-- day of 120 Signature of Property Owner Signature of Applicant F-Vl?If -riglmox Print Name of Property Owner Print Name of Applicant Notary Public Notary Public SHARI MELILLO Notary Public,State of New York No.OIME6160063 Qualified In Westchester County commission Expires January 29,20U (4) 3/21/19