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Home My WebLink AboutPP24-117 s N N Lo cn - x n. x �...� Lf) z z x W dq Myl Ey °' O Z o W a o x A O o W U w ° koz W z w O wv O w � O H ao � - F+1 L n W o 00 -_ 0) A z cn it A V - 1-4 ¢ W A Ho W - T zz z — w CY 04 w w r, z Q Q a �C w OE ' '� a 4 w x � y� DRC�U� BUIL E MENT JUL 2 9 2024 VIL E OF RYE OK _ 938 KIN , ET RYE B , J ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT nov PLUMBING PERMIT APPLICATION / I �J FOR OFFICE USE ONLY P#: PP#: �"7 �/ Approval Date: �� Permit Fee: $ czpm /"1 Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 7-��-�5� is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: �• i A t SBL: 13Si 7>-1- - 12one "� 2.Proposed Work: 3.Property Owner: Address: Phone#: %g-3F0—liv4'(l Cell#: 91q-516--59-1 email: 4.Muster Plumber: �� (� F p ,I,' Address: Z1(�� ,�C?)') � l�t rG�,1w f4 N Lic.#: �J Phone#: 9141 Cell#: email: 44 1t Company Name: Z i lr Address: 7!12-o ?o 17-ye 1 pcsO � 43 L- c oh44 � INDICATE FIXTURES& LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor 2nd Floor 3'a Floor 4"Floor 5"Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 6/1/2024 � r� ose,a� C�Re/f STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Lu r, ktl fi 7 Gz rrur ,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. r~ Sworn to before me this Sworn to before me this O day of 20 day of �`( ,20 5 � 1 Signature of Proper y wncr Signa re of Applicant Print Nam C4 Property Owner Print Nam uLApplicant l MICHAEL ESQUIVEL WAR Not Public Notary Public-State of New York Notary Public N0.01ES6442359 NOTARY PUBLIC-STATEOF NEW YORK Qualified in Westchester County BRONX COUNTY My Commission Expires Oct 11,2026 LIC.#01 OY6258379 COMM.EXP.03/26/2028 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. 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- 6/1/2024 IEC� BUILD J P. 1V1lENT VIL E OF RYE OOK JUL 90 24 938 KI1VG ET RYE BRc�` ,NY 10573 4�,� .-066�3. . wwvv� �:av VILLAGE OF RYE BROOK i BUILDING DE. ARTMENT� 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: ` 3, I-oi5 C)Q*vez Cgrrerg —, residing at, (Print name) (Addr whCre YOU live) 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; JJ- id 4p 6�, , Rye Brook,NY. (Job Address) 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. L�z -�' (Signature of Prope y wner(s)) i-,U i 5 C�qa ve-z r t-crq (Print Name of Property Oivner(s)1 Sworn to before me this day of l� , 20 (Notary Puhli, MICHAEL ESQUIVEL Notary Public-State of New York No.01ES6442359 -3- Qualified in Westchester County My Commission Expires Oct 11,2026 6/1/2024 QyE BRC�v� 1932 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 :- ) ] ACC_ S—T�LffP DATE: — Z Z UI PERMIT# L y ` ISSUED:-) ?y- 1 SECT: BLOCK: I LOT: J LOCATION: �q C 1, 4 S f �f CA- Ck OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... 0 ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS > ^ l ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL J vj !� c� V. OTHER �P,e c `40 'x41" ` 4 - I Y ` r Ah w