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BUILENT
VIL OK
938 KiN NY 10573(914)939-5801 D EC� V(L I----�``. '"-L�-7 I 1 '
MAY 12 2014 " �,�
PLUMBING PERMIT APPLICA I GE o
*MUST BE FILED BY LICENSED MASTER PL *
Date: Plumbing Permit CI- Building Permit#:
Fee: Approval Signature: '
(fees are on-refun ble)
Application is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit
to install Plumbing as per detailed statement described below,and in accordance with all applicable Federal,State,
County and Local Cod-es,,at the following location:
Address: (0 5- 1 0 mcXra C« ,`6 Phone#: ��L� 305- 3Y 7
Owner: y]C 4c r 0C)C Z G c-Address&Phone: (., i�4 m,-rc=c l t(d.
Use/Occupancy: Parcel I.D.#: Zone:
LICENSED MASTER PLUMBER'S INFORMATION: A
Name(please print): � / /IJ/l Phone#: y/`�9Vo od O G/
Signature: p Westchester County License#:-Z,22 o
Company N C -
Company Address: / S ��1vh/�'c� S/- City/Town: ,
State: Zip Code: Phone#: 9/y &b Q2 Q r�
FIXTURES&LINES ARE TO BE INSTALLED ACCORDING TO 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
1 st Floor
2nd Floor
Outside
*Other: I-Cc i zn _.!Cqn n l((-k' �lcl C/C1)3
Detailed Description of Appliances etc...:
�E BRC�uk
1932 BUILDING DEPARTMENT
❑BUILDING INSPECTOR
a�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.or
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : L T Q P l �% r i..L. DATE: Z�_-� 1,q
PERMIT# ?9 0('O 8 ISSUED: SECT: ,60 BLOCK: LOT: IV
LOCATION: t ����J OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... El ACCEPTED ❑ REJECTED/ REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS +- 1�—fC1 L C.7 r1 lJ-P I J y
❑ L.P. GASjcr _� �,Oc.J
❑ FUEL TANK \
❑ FIRE SPRINKLER l
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL ( N
Q OTHER L i N,�,j Cs l