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HomeMy WebLinkAboutMP24-148 s � o c w •� � v N N N � c•aa.a �+ 0 00 \ " O s ON w 1-4 oo � � U s � w O n c/a ti oA w a) W V) Q 71 W o c- a w w C © G 11 a o _ W 20 oo Z z A t-- a v v a C� o z _ W o qi ! z A C3 = z ° � v w 1' C ■ n v,Q ' v z w V V w U o v �r �"� P. O 'V, u a -U Cl, ud 0 d' � (� Q Fy $ 'o � •y � ° �' � ocn •> .04 N " W z F, d owe � •" a .n a RjEcE E 3D Nov - 7 2024 BUILDING DEPARTMENT VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK BUILDING DEPARTMENT 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 Fax(914)939-5801 "ii%,ryy broolc.ore APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING VENTILATION AND/OR AIR CONDITIONING E (UUIPM/ENT FOR OFFIO USE ONN(o`, PFRN1lT,a Approval Date: 11 V Permit Fee:S /oo 6 Approval Signature: Other: 14 Q)oO—/JV h/', l4 Disapproved. (fees arc wwretundeWeI }}!A******}*#*!!}itRfllifiltiff#!•#}#ii#fiw#}!#i#rdRidRlRbrd#}iib#dR#R#Riif*d♦►b!i#wwdiiRw#dR###RRk#k## REOVIREME\TS FOR RELEASE of PERMrr&CERTIFICATE OF COMPLIANCE: I. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability trtsuranee.(Village of Rye Brook must be tinted as certificate holder)&Workers Compensation Insurance on a NYS Board form(Form a(7105.2 or Form M t126.3 r or NY State Workers C'onrpcasaion Waiver) 4. Payment ofFees/Unit:RI-SIDI\TL\l SI i)n.nn unit•CYDN\-1FR('IAL S350,00,unit, 5. Inspection by the Building Department for removal and/or installation.(48 hour notice required) 6. Electrical work requires a separate Electrical Permit&Electrical Inspection. 7. Plumbing,'Gas work requires a separate Plumbing Permit&Plumbing Inspection. }}}iw#}riwwbwbwd*i*wwwiiw}liiwdbwdwribd*wwwiwwiiwwww}ww*wrwwdr!*ww**#w}*}haw#rw+wRirddriddd#iwdww Application dated, &312024 is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the IIVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in confomtance with all applicable Iocal,County,State&Federal laws,codes,rules and regulations IY I. Address: 23 Country Ridge IN.,Rye Brook,NY 10573 129.52-1-12 � 5BL: Zone: 2. PropertyOwner: Vinoj Siva kddress: same Phone#: 929-378-6790 Cell#: email: vinoj.siva�gmail.cpm Robison Oil One Gateway Plaza,4th loor 3. Contractor: Address Port Chester.NY it)573 Phone# 914-847-0295 Cell 9 email: Iweirgrobisonoil.com 4. Applicant: Same as above Address: Phone#: Cell;F email: 5. Scope of Work:New Installation( 1•Replacement(X)•Removal l )•Other( ): b. Lust Equipment: Replacement of condenser and air handler. Install new Bosch heat pump condenser and First Company air handler. 7. Location of Equipment: Outdoor condenser and attic air handler. R. Method of lnstallation/Reatoval(dint an equitimeoi needed r«1—fumi job): I h'IIR STATE OF N W YORK, [jNTY OF WESTCHESTER ) as —t� ! ,being duly sworn,deposes and states that he/she is the applicant above named, (prim rune of irdrvdual signing as the apptiarlt) and further s toat(s)he is al wner of th roperty to which this application pertains,or that(s)he is the �' e SA_ for the legal owner and is duly authorized to make and file this jpplication. (indieat.a act coatraa r,a attorney.en:) That all statements contained herein are true to the beat ofhis/her knowledge and belief and that any work performed,or use conducted at the above captioned property will be in conrormanee 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 ofthe Village of Rye Brook and all other applicable laws,ordinances and regulations ¢sue Sworn to before me this A Sworn to c nhe this dayof 711 ,20,�c( day of .20 Signature ofPropemOwner Sigrha p scant MrskukG RdHrkajJ- Print Name of property owrw t N of A h It / amanda K Olmstead M OEBO}y q}I l IP4MN p7�y pUpLIC,STATE 0t r4P.W YORK Notary Public Notary Public.State of New York Public ReghstntionSo.gl(1L6417632 No.01 U6336715 Qualifrcti m WFSTCNptTER Cnunty ().alined er,Westchester County Cnmmnse—F.xpiraear3o^.n?5 ;;ofnmissior Expires Feb"ArY 8, 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.Any application not properly completed in its entirely and/or not properly signed shall be deemed null and void and will be returned to the applicant. 6/1118