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BUILDING DEPARTMENT D ECENE D
VILLAGE OF RVO-BROOK AUG 2 9 2024
938 KINGS EE[ RYE BROOK,NY 10573
� 9114)939-0668 VILLAGE OF RYE BROOK
www.ryebrookny.i!ov BUILDING DEPARTMENT
FOR OFFICE USE ONLY: Q
Approval Date:SAP 2 0 4 PC-Qer 1 Application
Approval Signature: ARCHITECTURAL REVIEW
BOARD:
Disapproved: Date:
BOT Approval Date: Case# Chairman:
PB Approval Date: Case# Secretary:
V IV
ZBA Approval Date: Case# 41
Other: }}�
Application Fee PQ Permit Fees:&,t-)() 'C1
FENCE / WALL / GATE PERMIT APPLICATION
�Q
Application dated: Ord /—3 q is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit
forthe installation,construction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 250-6 B.(1)(g),of the Code ofthe Village of
Rye Brook,as per detailed statement described below., f
Swimming pool fences must conform to the State Code.
1. Job Address: (A)04Q 1 N� LAM OW (o'S 73
2. Occupancy/Use:. M S.B.L.#: /c) /i <f c� Zone:
3. Proposed Fence/Wall/Gate(describe in d tail):
Q tree_ t„/4I d?, W I ee s& i7 s t I t1 1.4
_ - WAtit �le,�ue - -
4. Property Owner: As1c"
Address: w %ou Woo cA 4p
Phone# Cell# n7 T S? 7-77 email: A-QkAk -'C.J''F' 'Q
Applicant:
Address:
Phone# Cell# email:
Architect/Engineer:
Address:
Phone# Cell# email:
Contractor: GUu' - k A 4'c'- l Wjj&L L L- p
Address&Phone: 747 0-,oUa-a. t W ...I o' �or TI�
5. If building is located on a corner lot,which street does it front on:
6. What is the estimated cost of construction ,3-7 O 0
(NOTE:The estimated cost shall include all site-improvements,labor,material,scaffolding,fixed equipment,professional fees,and
material and labor which may be donated gratis.)
7. Estimated date of completion: eAw
i
sttr2o24
Please note that 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:
,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 legal owner of the property to which this application pertains, or that (s)he is the
for the legal owner and is duly authorized to make and file this application.
(indicate architect,contractor,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.
Sworn to before me this 01 Sworn to before me this
day of , 20_ph day of ,20
Signature o P p Owner Signature of Applicant
ame of Pr arty Owner Print Name of Applicant
Notary Public Notary Public
SHARI MELILLO
Notary Public,State of New York
No.01ME616O063
Qualified in Westchester county
commission Expires January 29,20�Z_7
2
611/2024