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HomeMy WebLinkAboutPP25-028 L a oQ alN = N c N O ` \ w = N N N N N � z a o 00 c ena H a� � o O Z © w � � Z Q w � rn 00 �I �' � ✓J w , � �,o V 00 O o A F-+ � P.-O a w N � { ^ CA z 7 � C �1 Z z Cl) 409- Ci x L o@ Q 4104.041441.44104go goo go4944Qa.044;414141444;4;goo 4;664 - BULL DEPARTMENT VIL E OF RYE BROOK FEB 19 2025 938 Klld 'ET RYE BRO?O ,NY 10573 14j 939�Q.6 8�i VILLAGE OF RYE BROOK WWW e Y ' ov BUILDING DEPARWENT PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: D � Approval Date: '1`� \� Permit Fee: $ CD©0—1 Approval Signature: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated,c�)—/(�—C)L� is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State, County and Local Codes. 1.Address: :a U `' � �` vf� SBL:�3 � ���6 _Zone: 2.Proposed Work: 3.Property Owner: CA _ Address: '12) L ,Q rU;)r L#(`r f_ Phone#: C S q - Cell#: email: T 4.Master Plumber: :n7;�) ",-I lr (-f rl1 3 Address: -��'�/ ?'� T Lic.#: q 0% Phone#: /2- Cell#: email: -c- Company Name: 1 4 P/u,'^�_,T p F�%i�9� Address: G 7 1-101/r4nO INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement 1st Floor 2nd Floor 3rd Floor 4'h Floor 51'Floor Exterior V4 2 — 5.*List Other Equipment/Provide Details: S/b�N-,l- r-�JE'r 601/(' (Notarized Signatures Required Next 2 Pages) -1- 01+2024 BUILDJNG DEp( ggrMENT D ram' VIL��i�GE OF RJR OK938 KING STREETDD NY 10573FE$ 19 2025 (914)939- VILLAGE OF RYE BROOK www.rveb>rookrty.Qov R!! IDIN G DEPART NIi=NT 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: 3, canc 'sco �r �C �' fc�P��^v) , residingat, 3C' $.Toc- K Lahe Yf S-Iet,< N r t t'i f I Address where you tip e) 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; c,n e ,Rye Brook,NY. iJnh ;tid�3rr�,i 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. 16a[A Ci S C- Z_ C'P de-re, (Si g1 auu•c ul•Prntirrt� Cl��ncrl<I l a Y1 C G (( -int Name of Properly Chsuer{s)I Sworn to before me this AaoL- ,, 'i.t!-y,'L , 20s _ SHARI MEULLO Notary Public,State of New York No.01ME6160063 Qualified In Westchester County ComMIssion Expires Jnntlary 29,26-L7 6JI/2024 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 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. r Sworn to before me this Sworn to bef a me this f day of —� �"u ,20 day of ,20 r iCin SL caicleet,- — -'-� gnature of Property Owner S' nature of Applicant �ac7CisCo 'F (0f0�er0-7 �7 /,/�o/U/",�l✓di JPrint Name of Property Owner Print Name of Applicant Notary Public SKARI MEULLO Notaqj4)*1j*EULLO Notary Public,State of New York Notary Public,State of New York No.01ME6160063 No,01ME6160063 Qualified In Westchester County Qualified in Westchester County 7 Commission Expires Jandary 29,20 Z� Commission Expires JnnUary 29,2p[�7 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. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. z- 6/1/2024 �E BRC�� uJ � BUILDING DEPARTMENT ❑BUILDING INSPECTOR 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.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS:-� '1">P101.) ' DATE: PERMIT# RP 2 ISSUED: SECT: BLOCK: LOT: LOCATION: _-J VtA i 1-- 1 OCCUPANCY: ❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION Q NATURAL GAS 1 ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑'. FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER * o IN f\ * 0.0 ck en a * O o cz d w ate- v o s ri -6 zen ONcz ca* v t. * c� a� * t4j * E w v n * N y � L; �• C