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VILLA(;r•.OF Rvr [ w)oK D [ECIEVIE
938 Kum,.SrKtm' 11%,F RmooK, NY 10573
(914)939-0668 I DD
NOV - 6 2024
1�t1 i1.a1't'Itt'�ur�lt`1."�te1
VILLAGE OF RYE BROOK
INTERIOR BMDING PERMIT APPLI AT"G DEPARTMENT
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titgr"��;sl I'.;: Noll a '��n: cJ 7�d / / Applic.ttion !cv:$ `-
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1. Job Addr6s:1 �.f''� P- ' t f1 SEiI.:�l iJ�/ —/—c)L- lone: -/
2. I'ruiw3c3 Imptovctncnt. 1 tc.crick in J r,tl;:_ ��.M�Tl1 iG•'t,� +'�- ��t' [ sir_?T iC r— �+�'
3. Dk-se.the ptupired impr+ovomicnt involve it liputc-Occupation as per 51240-38 of the CcKlc of the Village of Rv [kw k'?
No: Yv,: Ify0 indi"c: I11:11 I: '1 Il;l( It: _1 IER 1I1:
I. t1-11 the prulxt scd prOject rcyuire t1w insiallaaiur,of a nca.or an cxtcnsion,nttxlitirutinn to an CXWISLAutomatic lice
aupprrssum:Ns,tcen l Fire Spi inkkr.ANSI.Sc.rc,n- 1 11,21ll"S%,re,n Net: Yew
�. (kcul?.tnc%: ,I i'lim.3 film..c"nruet_tic...►Prior to Construction: / f A r-r Allcr CoWntctiun: / _f-12 f7
6. NX Suic Con,trttctiun Cl.wilicatioa: N.Y.State the Classifcalimu
7, Prupcn% 0wric.-.
I"iu,nc Cell#1?d �) �?cattail: _ V"r�r 6-4 ,'7
8. �1p�lic:tnt; %ddress: J�j MQi • i^Ca i*�I'
Phone
9. Archavct Address:
I'honc�- Call :. cm ul:
IU. I:n;ir:t.,er. Address:_
I'Itone Cell - cattail:
I I. (ienrral t'onlractnr: ,j�Q, S/ t1 +'L Addn,�: _/�y ''1/u t.: r+:•+_.�. /--.�'. /'•;h�f r rr._� /brit:
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12. l:;tirnatcd c�,+t e,f rort,truelicxt � /C I L"eK: ��51 e'i- 2�t ��
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13. Job Tittwtable:Stunt: 11�3 t.W Y _ Finklu /7'�� C' a y
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Bu><Ln - MINT VIL E OF RY OOKR938 KING �T RvE BR ,NY 10573 pp;_
kn N.gov VILLAGE OF RYE BOOK
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:
I, rI)a vi'd K rp b y ,residing at, E I m h I Dr,
(Prins 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;
F (t c . ,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.
(Signature of Property Owner(s))
LQV. U )�"% �✓)
(Print Name of Property Owner(s))
Sworn to before me this
cUyof_ 20
V-\� I L
(Nolan PnbliC)
SHARI MELILLO
Notary Public,State of New York
No.01ME6160063
Qualified In Westchester county (2)
Commission Expires January 29,20K_1
6nno2a
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 entirety and/or not properly
signed shall be deemed null and void and will be returned to the applicant.
Please note that application fees are non-refundable.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
TL a✓J Lrti hr. , 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,allomey,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.
By signing this application, the property owner further declares that he/she has inspected the subject property, and that to
the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater
connections or sources of infiltration into the sanitary sewer system on or from the subject property.
Sworn to before me this ( Sworn to before me this
day of 20 al�1 day of , 20
Signature of Property Owner Signature of Applicant
Da V c,6( Jams- �
7Z77iA6
Print Name of Applicant
Notary Public Notary Public
SHARI MELILLO
Notary Public,State of New York
No,01ME6160063
Qualified In Westchester County
Commission Expires January 29,20ZD
(4)
6/l/2024
EXISTING TOILET
TO REMAIN
LOWER LEVEL RESTROOM LOWER LEVEL F.F.E.
m
WINDOW(TYP.)
EXISTING LAUNDRY EXISTING LAUNDRY
DRYER WASHING MACHINE
010
BASEMENT F F E \�
-4'-3't
] /10
EXTERIOR WALL(TYP.) STAIRS BETWEEN LOWER
LEVEL AND
BASEMENT
GARAGE F.F.E.
0'-0't
Fill COP5
1 LOWER LEVE BASEMENT EXISTING PLAN
Scale:1/4"=1'-0"
ELM HILL DRIVE PERMIT#SBL# / \
(/fC)- wage
DATE P E
NEW VANITY
till D1146 INSPECTOR,ViII of Ry Brook, NY
ECIE WIE
EXISTING TOILET
LOWER LEVEL TO REMAIN
NEW CABINETS AND RESTROOM
WINDOW(TYP.) COUNTERTOPS LOWER NOVLEVEL F.F.E. _ 6 2024
RELOCATED DRYER 0
C�\ � u
NEW SHOWER / I L�-A l.;i t.. OF RYE f3 F�Q O K
RELOCATED WASHER VBU11 f, P� G DEPARTMENT
BASEMENT F.F.E.
-4'-3't
�► ` \
v LOWER LEVEL RESTROOM
EXTERIOR WALL(TYP.) STAIRS BETWEEN LOWER
RENOVATION AND LAUNDRY
LEVEL AND RELOCATION
BASEMENT
GARAGE F.F.E
0'-0't
8 ELM HILL DRIVE,RYE BROOK,NY
10573
DRAWINGS PRODUCED BY:
DAVID KRAHN,P.E.
OCTOBER 1,2024
2 LOWER LEVE BASEMENT PROPOSED PLAN
ELM HILL DRIVE
A-1 00.00