HomeMy WebLinkAboutLearning Express Toys 2024 VOID BUILD MENT VVV F
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938 KING ET RYES BR NY 10573 8 2024
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FIRE INSPECTION. M ERATING PERMIT APPLICATION
FOR OFFICE USE ONLY: / 13
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Fee Paid:$ Inspection Date&Time.D
FEE SCHEDULE: % Re-inspection Date&Ti
Triennial & Private School Annual Inspection: =$450.00
Public Assembly Annual Inspection: <100 People=$525.00/>100 People=$775.00
Application,dated: �i1 ,is hereby made to the Building Inspector of the Village of Rye Brook NY,requesting
that a Fire Inspection b condu ted at the building and premises listed below for the purpose of issuing a Permit to Operate the business,
private school and/or place of public assembly in conformance with the Code of the Village of Rye Brook,the New York State Uniform
Fire Prevention & Building Code,Title 19 NYCRR Part 1201, and all other applicable local, County, State & Federal laws, rules &
regulations,as per detailed statement described below. , ,U
1. Address: [46 11�1;e 91 Q P10,71S�.�� SBL:,'��� a7—�—�Zone:e/'/
2. Business/Occupancy Name:�Y c�'^�° I' Tlj NYSUsee Class:
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3. Property Owner: W li��ElY� ( _Address:
Phone# 14-3 - +i3S Cell# email: -, �W
5. Business Owner: 'Mmij AAV&c Address ]pia air
Phone# ((�"� 4-`bl Cell#* V Y-09 733-01,00 email: • NL T
6. Emergency Contact: TS77 /KYEgS Address:-*?oy 212 Crrg& G k . AIT 100 9
Phone# Cell#'� 9�y-y3y-G�6� email:I` le Tbyj 1jr A Mse/(.[.e""
7. Inspection Escort: //yl./' y Ayws Title:Phone#: Cell#:"9/11- '?33 ememail: L43,Wn�
IF 0MA/t ff_
8. Provide a brief description outlining the current and/or intended use of the property:
USN� IN 61y?'r
9. List all Hazardous Materials: AACi
10. Occupant Load: Existing: Proposed: Other:
11. Date&Disposition of Previous Fire Inspection: Z111-1-bl' [ Pass ❑ Fail
1
8/12/2021
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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:
101
Jlwty /y'1L being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual signing application)
and further states that he/she is the legal owner of the property to which this application pertains, or that he/she is the
for the legal owner and is duly authorized to make and file this application. That all
(indicate architect,business owner,attorney,agent,etc.)
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 2 7 Sworn to before me this
day of , 20 2-+ day of " OLC-C,�, , 20
Not Public Notary Public
Signature of Property Owner ?- ig ure of Applic C
� rrut,a� 1AMes P M �e
Print Name of Property Gwrrer�A tIRV Print Name of Applicant
SHARI MELILLO
Notary Public,State of New York
RICHARD A.YARMY II No.n Westchester
Qualified In Westchester County
NOTARY PU:;LIC,STATE OF NEW YORK Commission Expires January 29,202--)
Registration No.OIYA0013323
Qualificd ;n Westchester County
Commission 1.x irm September 08 2027
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