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HomeMy WebLinkAboutPP22-002 ■ ■ a = ■ N � \ a ■ Rr a o 1.0 s W IF U a a� a W f 1 cG N 0ho ' r cMo `n O M en (Z Uen 00 1 0 `r) W 4 " A cs o A 4-4 Z o un c a F--{ A w � � A ^ M z 00 = O hJ-i 00 U z �c W ■ 00 w A. P4 w a c Z' VrA y� w ° P-4 W ✓ � � � a o � cn N 1 F o ILn T Ln z o G � D. BUILDING-EPARTMENT JAN — 4 2022 VILL. GE OF RYE BROOK 938 KING EET RYE BROOK,NY 10573 VILLAGE OF R`d E BROOK \( 14)939-0669 BUIL DlNi G DEPARTMENT w�r�I�ebratalt.org PLUMBING PERMIT APPLICATION 11 ` FOR OFFICE USE ONLY 13 P #: PP#: dc)­0 a d-- Approval Date: JAN 4 T Permit Fee: S —� Approval Signature: l Other: Disapproved: (fees are non-refundable) Application dated,/�� "cs 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 willbe in confo ante with all applicable Federal,State,County and Local Codes. 1.Address: ? a +'7 I Aj 4 SS t C flt•C r. - \PR1 SBL: 13 6•�k „ ` � " o�� _Zone: 1?,ig� T 2.Proposed Work: MFiv^ 4 L-ZAP �- "Ae N. J' A�l 3.Property Owner: 'L -&11 SAdWress: Cq< r/07 �S Phone#: 9111 60 ) �3/ - ell#: I' 'Y 53 (1 6b -)2 email: r`^6n2L/25 eAe•L • Co 4.Master Plumber:Vffl 1�Fit�� /��/. C Address:80. /_© 6,T'a RRAVR6416 ' IVI fa r Lic.#: Phone#:/l�'py�"Sy�eZCell#: email: 1�fR7S �r/ , /f�.IC Company Name: 6-0&TA0*7 r Address:. INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary NaturaU Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1 st Floor 2nd Floor Yd Floor 4rh Floor 5"'Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) 8/12/2021 S TE OF NEW YORK, OUNTY OF WESTCHESTER ) as: COY 0�1n1YGt1►�lCGJ�C ,being duly sworn,deposes and states that he/she is the applicant above named, (print nameCates ividual signing as the applicant) and funhe that(s he is the l ,or that(s)he is the L, L 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 t# Sworn to before me this 7 l S day of� '�'20 1-- day of A 4t r'7�^ ,20_�j Si a Sign re of Property Owner e of 'ca n st�� rf v c,sr.Aa G P/4.•r o�.w c-a* 0—& Print Name of roperty Owner Print Nam of Applicant ��1, &C tw.q:Y 1� "ZPubZliC/1' t-6f:P l.1 [J !�►v Fif A �L�� Aldo V. 'fltdgitano Notwry Pubhc. State of New Yorkin Westchester Coun SYIVI DEGIACOMO #01Va•727W5 NOTARY PUBLIC,STATE OF NEW YOI issir �K(1irA� 'T1?T'�'L Registration No.01DE6089490 Qualified in W stchester Runt Tl ' licatlon t st.�ie pry lc in its entirety and must include the notarized signature(s)of 1 }r�ottuntsstRn' xptres: the legal owner s of the sut5ject prope y, 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- 8/12J2021 ® `[ C � ' � BUILDING DEPAWMENT ` VIL E OF RY' OOK 938 KING ET RYE BR ,NY 10573 �AN ' 4 ZQ�2 j � ):704 x� VILLAGE O1 —YE BROOK BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 r 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: .J, Ls rA M n r- TO &r t, G I/�AO 'r jll' `re ding at, S WA LO 6S rr I-i G 5 r&A Res"two g ';0*1J 04 C X4 k, M•y (Address\%h re vuu 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; . J Rye Brook,NY. f.lob Addra�sl 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. 0/:;� t C­ S, f3 G-V e"r" *J Signalure of Property Ownc ,y.,J (y R C—S r �k � l c I C-1% F S i kk TZ- a f- 7 �S G,n�. `r ea..e ys a (Print NaniL: c r('o 1 Sworn to before me this day of 1' I �..h �e ,r 20 z 1 r (tip Puhlicl SYLVIA DEGIACOMO NOTARY PUBLIC,STATE OF NEW YORK _3_ Registration No.01 DE6089490 Qualified in Westchester Count, s�izr�ort My Commission Expires: �cBR.0 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 - - - - - - - - - - - - - - - - - - - - 1 ADDRESS :— 1� 1� � C�c � I i �' 1 ` DATE' t T-2 cJ?� : 1 S PERMIT# \ ISSUED. JECT: BLOCK: LOT: LOCATION: * � � \L OCCUPANCY: J ❑ VIOLATION NOTED THE WORK IS... ff ACCEPTED ❑ REJECTED/REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING �1-�' , ' L ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS �aA, ��� ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ' ❑ OTHER * * * � ` * v �Y F c °�° C° y� , * Q F � 0.6 00 * O ! V * d o rj cl > Lo GJ 3 0 * o rV