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HomeMy WebLinkAboutBP25-025 _ Lin V N NpZ abi m N 7.p. : \ T � a p o Cn L' �" a ° A ° ra � M � Ga � N o Z U y ti g v lr+l xj N - ;;600 Z O C w V Q0 uo o W V Z v - j..� 04Ix o Q t U o rm 1-4 a w `d A v 5 b M i H O z o a w A U V U " o 04 cr 441.0 w F O o o F-� O V O H $ a o - M u t w � t � p Z W od . a BUILD MENT vu. .., oOK FEB - 4 2025 938 KING ,NY 10573 VILLAGE OF RYE BRQOK ov BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION OR OFFICE USE ONLY: pproval Date: FFR 1 2 0 t Application Fee:$ Approval Signature: Permit Fees:$ Disapproved: Other: .*+•*,tr,r**«**«*:*c*�*«*,e,r*t,r*****«#*,r,�**�.*f*�****«**,r,►****,r,r,r****��*�**,t*,r**+:,r,r«**,rrr:***«t+***rrr*�**,e.****e Application dated: — 7`cis is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the terior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: I H(0 6/f t 1,W k Ld C -L"CX4&& SBL: l c�9, 7 6— Zone: YJL/ 2. Proposed Improvement.(Describe in detail): lc—ECif` J (��C _ "✓4�.1 G•9t .'-r r�u s �i X TJwr< a 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: 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: 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: After Construction: 6. N.Y State Construction Classification: N.Y.State Use Classification: 7. Property Owner: qoM t, M A.-o--i,s o n Trust Address: (100 bnS t e(at ��i Lt2 F-L. .03,401 Phone# a1 g g Cell 4 4- 484—13 Qa email: �+�Ohl °� �l~A b e_.n� 8. Applicant:b O,n�f c Co�4n Tr steli Address: 1 Q 6d inns L,(a , ( f.. �i L is ! Phone#h)Q., Cell#17(4^ �'�' 2._email:t3 Ca tl Xr+J C NE Hd C.n 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: ,5 Phone# Cell# email: 11. General Contractor g y C o•✓7ft4 cr an s' VvAddress: /S'_// /3 vJT4f ;z-2 Su-i f AFW4;ci/VL Phone# YIV //y 3 --// / ) Cell# /S'— 0-7 -i o email:k`r 4 Z ey­fM Cr-an t' i Y< 10 G.H.4•'c 12. Estimated cost of construction $ _?Z © -:;, 0 (NOTE:The estimated cost shall include all labor,material,scaffbMing,fixed equipment,professional&,es,and material and labor which may be donated gratis.) 13. Job Timetable:Start: Finish: 61112024 BUILD MENT Vim. oOK FEB - 4 2025 938 KING NY 10573 VILLAGE OF RYE BROOK w ov BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE V 16 - STORM SEWERS AND SAMTARY 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: a9 _A_ CCHA-EA residing at, qU a (Print name) (Address where you live) eing duly sworn,deposes and states that(s)he is the applicant above named,and further states that(s)he is the 1 Dgal owner of the property to which this Affidavit of Compliance pertains at; U # L.LO yJ CfAIE 5g-r , Rye Brook,NY. (Job Address) t Further that all statements contained herein are true,and that to the best of his/her knowledge and belief,that ere are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further at there are no roof drains,sump pumps, or other prohibited stormwater or groundwater connections or sources f inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, ounty and Village Codes. i - 6&' .0�0 (Sign&ae of Property Owner(s)) (Print Name of Property Owner(s)) T Sworn to.,before me this rd tolf , 20�1 : ' : TRACY LEWKU7Z Commission S HH 563803 Expires August 19,2028 (Notary Public) (2) 6/I/2024 i 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. TATE OF NEW YORK,�O N Y F WF�S�CHESTER ) as: i°l1 `fPt� Wig_ ¢ C,`ieIng duly sworn,deposes and states that he/she is the applicant above named, Ibrint name of individual signing as the ap licant) `nd further states that Whe is the legal owner of the property to which this application pertains, or that (s)he is the 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 Sworn to be re me this )td day of lA , 20 /(Y', day of Signature of Property Owner l' Signature of Applicant PriJLLName ofPrope weer Pri t ame ofAppii i L Notary Public No ry bhr i 1 ` TRACYLEWKUTZ ,�; �" TRACYLEWKUTZ A Commission#HH 563803 Commission#HW 563803 '•'.' '°. ;, °, Expires August 19,2028 f pa no� Expires August 19,2026 rpoK F'oPr 3 i� 3 I I )4) i 6/1/2024 i