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HomeMy WebLinkAboutPP25-020 C C c oN � ws : Cq � w ►n ' w �1 04 44 O It z u Cl) CA Le) z a � O � o en � F' z � O A ° O v, z � z �—+ 00 Q w W W M w � v H � m Q � * r x A o z - A w x p 0 w z z p ur) p ® �n PLO BUIL G EP '> TMEINT FEB 1 2 2�25 VIL »OF RYE OK 938 KING ET RYE B NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT �ny.gov PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BI, #: 1'I'#: a's__ 0 Approval Date: FEB 1 2 2025 Permit Fee: $ Q)®0 ` P6 Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UN`I II. A PERMIT 11 %S BEEN ISSUED BS' I'llE BUILDING INSPECTOR. THE ADMINISTWkTIVE FLE FOR NN ORK PROGRESSED OR COMPLETED WITI_IgUT_A PERMIT IS 121%OF THE"I'0TA1,COS'I OF CONSTIZUCTION WITH A MINIMUM FEE OF$750.0 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. I.Address: 271 North Ridge Street Rye Brook, NY 10573 SBL: L3, , c�7— —ad Zone:/c—/'— 2.Proposed work: Repairs to a hole found in the sewer line outside of the residence 3.Property owner:Eugene & Lanna Hertzberg Address:271 North Ridge Street Rye Brook, NY 10573 Phone#: Cell#:914-318-7467 email: Lanna.Hertzber mail.eom 4.Master Plumber:,I'1lkCIL Address: IVI - r Lic.#: IZ1 email: Company Name:MP D Pl u4M 6.1 4- PCW' 7 Address: 1911 �. �� ` .Z070} INDICATE FIXTURES Bc LAVES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Rath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement Ist Floor 211d Floor Yd Floor 41^Floor 51'Floor F,xterior X 5.* List Other Equipment/Provide - Provide Details: �j �y�_ .A"1 t( � ct,) � C'Q." �1 -_ ...__._._. --- -- (Notarized Signatures Required Next 2 Pages) 1 1 , STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Mi AAX, ' ,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 Master Plumber for the legal owner and is duly authorized to make and file this application. 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 Sworn to before me this S day of 30A" (1�,20^�5 _ day of ,20 9-5— r Signature of Property bwner Wgnature o App scant Print Name of Property Owner Prin amc of Applicant Notary Public N pLQVC,STATE Rachel Ferder gistration No. 05DE0000850 NOTARY rueLIC,4fATEOFNEWYORx Qualified in Putnam County Regiuralio0 No.©IF 66366337 Commission 1*xpires �Phr tary 6. 2027 Qua li Ged in V�(mchester County Commission t sffires IOf3N21I25 This application must a pio�1`ty�1� tirety 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. Applications not properly completed in its entirety and./or not properly signed shall be deemed null and void and will be retuned to the applicant. -2- 6/1/2024 B • � �2K� R MENT UiL'f1�N .'� VIL t OF RYi OOK RFEB 12 2025 ,ID 938 KING kT FT RYF,BR y NY 10573 -04 VILLAGE OF RYE 13R0©K wwwol*yc Wookriy.Qc1.V i BUILDING DEPARTMENT I 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: 31, LlfNI-)A u�Adk rt'l , residing at, LZ4l �x�ckl N`� Its i�3 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; .A k1t p_.XZ 4, tO k)543 — , Rye Brook,NY. 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. —�� �1& 011gillour..nl Pro►Tarty )uhcrl� 11'r'nl \,unc,,I'I'rnliei[N' Sworn to before me this �- day of . Y , 20 2< IA,1arc l'i ! ' Rachel Ferder NOTARY tUBLIC,STATE OF NEW YORK Registn►tioo No.01 FE6366357 Q►utif►eb in Westeheater County CaS M111lan Expim t0130I103S 6/112024 QyE BRC�� 1982 BUILDING DEPARTMENT ❑BUILDING INSPECTOR 9-<SSISTANT 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.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : 1 ,v r P. '` Si Jg DATE: PERMIT# �P - O Z ISSUED: SECT: 3J ' i BLOCK: LOT: LOCATION: OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION .Q UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER M c._ ❑ FINAL PLUMBING ❑ CROSS CONNECTION 0 'FINAL `0 OTHER r .� . r ti{. t' .' ;1�. �. 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