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HomeMy WebLinkAboutPP24-126 - O a s N 00 00En N W PLO 00 °� - p v 'G'o rJ V z � Q O Z cn x r--+ x W H zz O C ° .� - _ BUILDING DEPARTMENT a VILLAi?< E OF RYE 1.j1ftOOK EMED 938 KING,'*,)WET RYE Bl jc,NY 1057 AUG 12 2024 VILLAGE tivv &a&k(jo nLg OF RYE BROOK BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: Q / — / =:� G Approval Date: AUG 1 11 Permit Fee: $ t now 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, 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: 3 1� o k 1�s�3 SBL: A:4, Zone: e/S 2.Proposed Work i i Co k Alta. eF �►n ��. ly►�-tV���,�a�a c�e C, KUe.w &MAxy-L,s.�yW6cO�-cArb ' L uA `Ekrea��, 3 Proper Owner: he Nk ru�� D ,�IYP 4009 Address: Phone#: Cell#: email: 4.Master Plumber: 111ow►as Wtb)X�7' Address: N Lic.#: Phone#:"Pgs 1.6S-Neo Cell#: email. Company Name: . Y'e.bb..r Address: 3365 05 1 . Cef4 sye'', Wy 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'd Floor 41 Floor 5"Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) A- 6/112024 STATE OF NEW YORK,COUNTY OF WESTC14ESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, ; (pent name of dividual 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 Eire Prevention&. Building Cade,the Code of the Village of Rye Brook and all other applicable laws, ordinances and regulations. Sworn r"before me this Sworn rkkks efore me this t day of ►.� , 20 day of .20 i`e ahzm ofProperty Owner Signature of Applicant Prim?tiarrte of�r©perty Owner Print Name of Applican, !140t3gy lic' WILSONALCANTAM Notary public-state of New York Notary ublic NO.01ALi114415 Qusioted in Westchester County My Commission Expires Jul 6,2025 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. Applicatio not properly completed in its entirety and/or not properly signed shall be deemed null and void a ndjuikbg- returned to the applicant, k ANNMARIE D'AGOSTINO Notary Public State of NY Registration No.:O I DA6045979 Commission Expires: August 20 ram; _z- 6/1/2024 i r BUILD MENT VIL E OF RYE+' OOK 938 KING "` ET RYE BR NY 10573 14)939 ww�!v�T e �eov AFFIDAVIT OF COMPLIA CE7GE OR RYE BROOK 'VILLAGE CODE §216 - STORM SEWERS AND SANI Ky 8U1! INC ( �=PARTMNT 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, G� , residing at, 65q A 1 d Gf TO/'1 (Print name) (;Address where you hvc) being duly sworn, deposes and states that (s)he is the applicant above named, and further states that (s)he is the, owner of the property to which this Affidavit of Compliance pertains at; ' • �1 �- 4d 4 Rye: Brooky NY'' (,doh ddress) - Further that all statements contained herein are true, and that to the best of'his�her ge,knowled" aid belief,that . there are no known illegal cross-connections concerning either the storm sewer or sanitary seay��,and£umber, 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 Sta County and Village Codes. (Si�natEre ofProper2y O>vner(s)j {rO� VI flU` d� (Print Nance ol'Property Ownegs)) Sworn to before me this J day 4PLIbc) ✓S , 2(}� (Nota WIL5ON ALCANDkS rotary Publtc•State NO.DIALNI9rin Westche -�-►FyCommisslun€><P€re �yE BRcb, o 1932. BUILDING DEPARTMENT ❑BUILDING INSPECTOR 0`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 : /� /l/ y T ej b C7 f -C,/ ,69-7- DATE: L 7 - Z ULz PERMIT# �)� 1 el- ISSUED: �5�e'l SECT: BLOCK: LOT: -� LOCATION: 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 1 ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION pD� ❑ FINAL �/I Q KJ Sr54 & ❑ OTHER QyE DRCu',-. Fb 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 : i �> c)1`T DATE: PERMIT# ? T 2 `1 1 7 �G ISSUED: SECT: BLOCK: LOT: LOCATION: Sr r G uot7 CL4 c OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED 2 REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS F1 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING i ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER ve . ice- I --- 0 0 (`) FI td Q OQ 1 .0 LOIJ �1 _ td IF� lea I I r I I