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D BUILDING DEPARTMENT
FEB 11 2025 VILLAGE OF RYE BROOK
938 KnNG STREETRYE BROOK,NY 10573
VILLAGE OF RYE BROOK (914)939-0668 FAX(914)939-5801
BUILDING DEPARTMENT www.ryebrook.org
PLUMBING PERMIT APPLICATION
FOR OFFICE USE ONLY BP#: PP#: o1S- /8
Approval Irate: Permit Fee: S r
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
Application dated, 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 will be in conformance with all applicable Federal,State,County and Local Codes.
1.Address: 80 VALLEY TERRACE SBL: /3-5-/s/-1-73 Zone:
2.Proposed Work: REPLACE EXISTING HOT WATER HEATER AND INSTALL CONDENSON UNIT. --
3.Property Owner: NICK CARTOSSA Address: 80 VALLEY TERRACE
Phone#: Cell#: 561-715-8418 email: NICKANDABIGAEL22@GMAIL.COM
4.Master Plumber: Sal W Morlino Ades: 1 Bonwit Road Rye Brook NY 10573
Lie.#: 725 Phone#: Cell#: 914-260-1592 email: salvatoreserious@gmail.com
Company Name: Westchester Plumbing And Heating LLCAddress: 1 Bonwit Road Rye Brook NY 10573
INDICATE FIXTURES&LINES TO BE INSTALLED AS PER 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 1
1st Floor
2nd Floor
3'Floor
4`h Floor
5h Floor
Exterior
5.*List Other EquipmenVProvide Details: INSTALL NAVIEN NPE 240A2 CONDENSON HOT WATER HEATER.
(Notarized Signatures Required Next 2 Pages)
11/27/18
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Salvatore W Morlino 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
Salvatore W Morlino/.""d 1/1 1 ✓9LC.�Q4or 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 /177 Sworn to before me this 11 7-
day of 1`-4 A ,20 Z day of j� 20 ;V—T
C&40em' 6Ab� --
Signature of Property Owner Signature of Applicant
NICK CARTOSSA Salvatore W Morlino
Print Name of Property Owner Print Name of Applicant
Notary Public , V+;0.lM�q—Nc' Notary Public
plwtvit�'4t��3it `�ot"F
`!'.'�.
a n 45S6t,
This application must be properly completed in its entirety and 0 rized signature(s) of
the legal owner(s) of the subject property, 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 br
returned to the applicant.
-2-
11/27/18
BUILDING DEPARTMENT V
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573 11 2025
(914)939-0668 FAx(914)939-5801
NN N'k%-".rvehrook.orQ [VILL'AGF=
UIL f! OF RYE BROOK
- DEPARTMENT
*#######***#*#*####**###*##**####***#*******************#***#**###******#**##*kkkkkkkkk#kkkRkkkkkkkkk
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE 4216• 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 FOF" WILL BE RETURNED TO THE APPLICANT.
STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as:
jf, NICK CARTOSSA , residing at, 80 VALLEY TERRACE
-- ,Trutt neunc� (Address%%here cou Inc)
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;
80 VALLEY TERRACE , Rye Brook, NY.
{)ob:\ddress)
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 Propen%U;.ner(s))
80 VALLEY TERRACE
(Print Name of Properi% Ott ner(s))
Sworn to before me this // T -�r�,tC g,•,�O
day of 120
,/1/}� 9Ci1/4E111' C► T1�'''�i
(Notar% Public) .
11/27/18