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HomeMy WebLinkAboutPP24-150 o N N .. _ N � ccn � W v a N m w = � r� F a W ° _ biD p4 r 00 w M Ln V CN x z ' o V = M O W U Cs o +Z U © z v " �It Z = � �44 W p � 00 W (� V O 7 ` ti G� PG U IR ■ ■ z � p o < u� o � z �I a a ;L41 cn D ECENE yE.,QRC�. BUIL E MENT R $ P z 4 2074 DD VIL 'Ae.E OF RYE*- 938 KING STREET RYE BR' ,NY 10573 VILLAGE OF RYE BROOK (9147 -0668 BUILDING DEPARTMENT ��vvv.xycbrooknv.goy PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP Approval Date: -J — Z 1-1 Permit Fee: $ CDC C) `'P �U Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS SEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%n OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, 9 is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install an&or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said pillimbing w k 0-i formance ith all applicable Federal,cS�tatee,County and Local Codes. 1.Address: SBL: 10,!, !S 1-`Q Zone: 2.Proposed Work: 3.Property Owner: Address: jV, ; e Phone#: — Cell#: email: JCL t✓Q 4.Master Plumber: Address: Lic. #:$ff9 Phot a#: Cell#: email: C, Company Name Address: r INDICATE 1XTURES 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'Floor 41h Floor 51 Floor Exterior 5.* List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 1 6/I/2024 ST E OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he she is the applicant above named, (pn t name of indi nl,igning as the applicant) and further states that(s)he is the blaster Plumber for the legal owner and is duly authorized to mare 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 Ot� Sworn to before me this 3 _ day of 20�- day of_ 20 t� Si"9 re o Property Owner Sig, w1ure r \pp i t ne Al, Print ame of Propgrty Owner P ' t Name of Applicant \,nan tt - Notary Public PAIAR hl 5 LOMON SfiARI tVtELlt LO Notary Public,State of New YO(k Notary Public.State of New York No.02SO4990393 No,01ME6160063 Qualified In Queens County Qualified In Westchester County Commission Expirt3s DBCBtslber 30,20,E Commission Expires January 29,20 Z,-7 This application must be properly completed in its entirety and must include the notarized signatures)of the legal owner(s) of the subject property, and the applicant ofrecord in the spaces provided. Applications not properly completed in its entirety and/or not properl\ signed shall be deemed 1Iu11 and void and will be returned to the applicant. .,. 6/1.no�a BUILDING DEPARTMENT VILLAGE OF RYE BROOK S 24 2024 i 938 KING S'rREET R E BRO � O-K,NY 10573 (914)939-0668 ; VILLAGE OF RYE BROOK NrwwxvcbrooknN'.L1ov BUILDING DEPART MENT 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: PaY )e-- residing at. 191G No IPrinl namcl (Address%here%tW Iicc1 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, Pkll Rye Brook. NY. r ( oh Addressl Further that all statements cost -ned 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. (Signature of Ptt)Pcm 0%%nrri•.l i4 _ 1 _w c C x IPrinl Name 441'ropm% O%%nerlsll Sworn to before me this a day of 20:)K J��r \iq.n, 1'nd.licl �' 7-d UN ENOTARY OF NEW PORKY4930490 SCOUNTY ay 09 2 6/1 P-024 QyE BRC�v�t -I-- 19t32 BUILDING DEPARTMENT ❑BUILDING INSPECTOR D'USISTANT 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 : 2 A o/` / /`7 le 6 l U` PERMIT# Sy ISSUED: ' Z �/-2 SECT: ��/• 7� BLOCK: _LOT: 26 LOCATION: Ll d N7- P l&- 1/ T >1,41,Z �,-> 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 ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER •� �� ``,/ f`, +�r�• lam+ � V� . A -V t \� ' � �' � p � �� ...�_. .�.: � � � , - � �� y�, ,� iR, Y ' y t + _- � l /�. 3 ,� ' - � Y s. ° ice, -� ,_,� �s. '' °y'�=� •�'....- �'��;"" y_ — .� ;ate' ,�. . ��z" .. �e�[,� .s f � ` _ ! •.` � �. � c� 4'. �� ;,�; ,�' tt .off �, �� '