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BUILD MENT 1�J
VI L E OF RY OOK DD
938 KING ET RYE BR ,NY 10573 DEC 00 2024
1.4)93 -0
ov VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
INTERIOR BUILDING PERMIT APPLICATION
FOR OFFICE USE ON Y:
Approval Date: 1 Pern ' �� Application Fee:$ 1 6
Approval Signature: Permit Fees:$ 1
Disapproved: Other:
Application dated: t Z 3e is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the
interior alteration of an existing building,or for a change in use,as per detailed statement de bed below.
Ia pp +� �S P(A Cec�m7 I+tneA
1. Job Address: Q h� Ituut SBL f'7�t 7—/—& Zone:
2. Proposed Improvement.(Describe in detail):Remodel existing female bathroom.New Tile, Paint, New stalls
Like for Like Replacement of Fixtures.
Instead of 4 stalls there will be 3, and one of these will be ADA. Enlarge bathroom entrance door
to make Move toilet flange slightly if necessary to make stall ADA.
3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook?
No: X Yes: If yes,indicate: TIER I: TIER II: TIER III:
4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire
suppression system(Fire Sprinkler,ANSI.System, FM-200 System,Type I Hood,etc...) :No:X Yes:
(If yes, please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: Retail After Construction: Retail
6. N.Y State Construction Classification: ,� N.Y.State UseClaClassification:7. Property Owner: WW tp� FAH y JUL Address: � Pic R ,, (XA
ZA
Phone# 4K-- -{ -KA7 Cell# email: Aq-A fJ3t*VyTr4ft -,''iyV\
8. Applicant: Dectech Mechanical Corp. Address: 340 Saw Mill River Road,Yonkers NY 10701
Phone 0 9143493323 Cell#9143163209 email: DECTEECHNY@GMAIL.COM�� ��11
9. Architect:Jf1hLOf- Address:S N ��7 �u`�l f 1Atil�S INl
Phone# (i 1,V) '001A Cell# email:JTP— TNUXWz1kA(ECK, Wr' '
10. Engineer: Address:
Phone# Cell# email:
11. General Contractor:Dectech Mechanical Corp. Address: 340 Saw Mill River Road, Yonkers NY 10701
Phone#9143493323 Cell#9143163209 email: DECTECHNY@GMAIL.COM
12. Estimated cost of construction $ 46,000.00
(NOTE:The estimated cost shall include all lalwr,material,scaffolding,fixed equipment professional fees,and material acid labor which mat be donated
gratis.)
13. Job Timetable: Start: 1/6/2025 Finish: 2/10/2025
(I}
6/1/2024
BUILD MENT
VIL OF Ry OOK
938 KING ET RYE BR ,NY>10573 DEC 3 0 2024
� � 9 -c
w ov VILLAGE OF RYE BROOK
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, �` t1 f r , residing at, 29" R`lIi;
(Print name) (Address where you lime)
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;
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.
(Siena C4 :- �J"
(Print Lame of Property U» .
Sworn to before me this U�4 \
day of Q . 20 c'-_�L 'I
)CIF ORUNELLI
NOTARY Pk I IC,STATE OF NEW YORK
(N ry P��hr�) Regisr_'(ion ha. O1BR6I46106
Qualified in v:` TCH1wZ CQUNTY Coanty
COmn,.iss;on Expires MAY 15,2026
(2)
6/1l2024
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:
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
CL)NW-ACTNL _ 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.
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 3 lo Sworn to before me this
dav of DEfYI , 20 day of DBLJE�n 20
Signature of Property Signature of Applicant
MAIA--4kgalj 0fWt t_L Mlc E LI M-Troro
Print Name of Property(Omer �__NT Print Name of Applicant
Notary Public Notary Public
SUSIE BRUNELLI SUSIE BRUNELLI
EQualifiedinWESTCHESTERCOUNTY
PUBLIC,STATE OF NEW YORK :�rARY PUBLIC,STATE OF NEW PORK
stration No.01B County Registration No. 01 BR6146106
tlalified in WESTCHESTER COUNTY County
ission Expires MAY 15,292f? Commission Expires MAY 15, 2026
(4)
6/l/2024