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HomeMy WebLinkAboutPP24-141 a N T-4 N N W = QI 7 z a a v ow o cis W O � � W 1 O N ON RT�1 ' z 0-4 z V 00 'A A H v z a cn Wc� p �n W c� �, w � o O 00 O x zz ,4 o � a w � x W O y..� G o x a = V Ho a W V © 64 W � N A W W � m - D ECQI� BUIL ING 10E , IT SEP - g 2024 V1L �E OF RYE OK 938 KIN ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT W nov PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: Approval Date: SEP i Permit Fee: $ L;I?C1 d Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT IIAS BEEN ISSl1ED BY TIIE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR N4'ORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COS"r OF CONSTRUCTION WIT" A MINIMUM FEE OF$750.00 Application dated, P I q oZ 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: 7.4 Pwtly f0jjr J5Ikjd ,9Ar 5 0V ihj'i M513 SBL: f79 13 - -5S -I Zone: #�Ut 2.Proposed Work: Nat :n► 6rk, ,fir 1 n J ror1 7fS* a K ne erlie 3.Property Owner: SLih �npr3,ltt, PreSijfyaC Address: (1' Phlnt Clh�rI P ,�1��( } NY I(>i73 Phone#: Cell M (Q kA)q(lih- Dg2a _email: L�UI� ,tp jna a7 - 4.Master Plumber: fsresicicnnal• om Address: i2Q1H1 CnndY�a alyGiy Mt11cmUxt• >`1Y #05ti0 Lie.#: 14gC5 Phone#: Cell#: email: A>"L !id)q i 1.C�YY1 Company Name: DSilkla 211ilmhrl, t a e(jt���.Address: i�Cs��! Cnnrlfn►rrlt�►ur1 Mi.MeyAO4l4Ylb��O 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 / J 1st Floor d 2nd Floor 3"Floor 4'h Floor 5'h Floor Exterior 5.*List Other Equipment/Provide Details: p 11r9r l mat ey , Ponk berg tf i'S (Notarized Signatures Required Next 2 Pages) 6/112024 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Z"csf/✓-i ,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 6-4- Sworn to before me this day of ►t�t'L ,20 day of 20 6S' ature of P y Owner r r Appli in�� �,.�a GJrv�.6 �5 fU�-!�.V/�"1 r�``C' �/�JI� /{• �fI ,lLY/7f' Print Name of Property Owner Print Name of Applicant h,,-,,, Notary Public MICHA.EL A. NAPOU I k, Notary Public Notary public,$tits of New York IIICFM &A.NAMTANU Rep. No. 02NA4888695 Notry P%non">lVl of New Mork ~ March 16, 2Q L M nw Cd1111wi0H JBIpI1Mc March 16, 2 " 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/I/202a BUILD MENT � ~ VIL E OF RY OOK 938 Kirk FT RYE BR NY 10573 $gyp - 9 ZQ24 �(914)939-06 NN WIC rvet iuokn . ov VILLAGE OF RYE BROOK 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: slc.k �yeSrc� D �rMr�v r�;t^-'tI �Ssac, �'^ �r&Je_Fcqrtes ding at, r f rJr i Yc e �i(Dok /�5-73 (Print name) (Address where 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; Vd /— e s /OS 7-3 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. 15Z (Signs e of Property er(s)) u L a �i f 1/e S!��n o / Ili Y HU1'x-�r� AaA-f- �o C, 5 et& 5l m 1 (Print name of Property Owner(s)) Sworn to before me this �p day of 1 UGC (Notary Public) MIC ML A. NAPOLITANU Notary public,State of New York Reg. No. 02NA4888695 Gualthed In Westchester County Commission Expires March 16, 20 (e ? 6/l/2024 �E BR(��• 1. cu � '932 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 : 4 t_3� ,,�.'� A DATE: 1 O- 1 - Z O Z Y PERMIT# T? �, ` 1 ISSUED:'i SECT:/L V. 73 BLOCK: Zr LOT: �O J� I LOCATION: �A S2 r`1P ��Q 5� i �a= �o M Q 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 0* NATURAL GAS �1LIl�Sl tl� C Lt— G4-,S Pl ❑ L.P. GAS ❑ FUEL TANK r ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER c * o * co * * co * v N fN * -dTIC \ \ M rl * O .cz K. v 0 * CV.1 Q. c � z `l o v Q Q A s W p �" M b c N v aGQc � cl v L G7 * V ° a ZwW � -ci Z v v z ^ * co � x � a W ' 00 - � M * O x * o V7 N * v 3 0 * �o O U * o U * N O . a o o