Loading...
HomeMy WebLinkAboutBP25-043 - CV s aj O ad a Z in z a p 1 H M p � VS 0. x •2 ° W LOtq W CN - " 00 W w a az 1-1 � o V Cjr�-tt 0-0 Q� (- V w w � m 11 CN �T� y uxy (f} a o °a 44 1� z � 'd p4 z V o V ; z Wo �+ 50 z w w o od . AZ z © 90 � 6 _ Burn NWNT VII.,4 E OF RV16 OK OCT 1 1 2024 938 KING ET RYE BROO •,NY 10573 (91.4)939-0668 r., INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE��AR 1 2 2'025 rr� Approval Date: Perm*i -S _Q Application Fee:$ / 00 in Approval Signature Permit Fees: $ C) Disapproved: Other: ..::.,:,xx-xx:�xxxx, x,�xxxx��x,�xx,�**x.**.*...,.k...,���x**�***�*..*,,**.x*,.**��***,«,►..***..,.�wx, �,xxKxxxx;:;x,�,x,�,� Application dated: �0 is hereby made to the Building Inspector of the Village of Rye Brook.NY,for the issuance of Permit for the interior alteration of an existing building,or fo�r"a change in use,as per detailed statement described below. 1. Job Address: �t 1 I�1 Q KJ y I lA QG SfRe—t SBL: I J:35 . f - f - 75 Zone:_ 2. Proposed Improvement.(Describe in detail): Le ctcL '� - SeGO✓lG fl0 d k- b'Ae tz J(M q Vid 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 1: 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,ANSL System,FM-200 4vstem,Type I Hood,etc..-) :No: C Yes: (If yes.please submit a separate Automatic fire Sups .tn Pere pplication&2 sets of detailed engineered plans] 5. Occupancy,(I fam.,2 fam.,comm..etc...)Prior to Construction: faiM �/ After Construction: 6. MY State Construction Classification: N.Y.State Use {Classification: 7. Property Owner: 1G�I�JIe doss Address: q� 0't! R` ct�� Phone#q 17 -11 Cell# email: M 1 h ros � 8. Applicant: Address: } O0 Phone# q,�11- — Z Cell# ` email:I �,I,,,,, Q I` 'G�A 6 149. Architect: ri�' Iota W r 2Address: l�O L1 V1G04 Vl T�+�it' the % RWe Brpo Phone# ' 4(o' _54-3 02 Cell# (A(o-Z/J" 370 Z email:NA 1 Address: �macgayi - Soft (taarz:k eAUT. 10. Engineer: //�� J"o COW1 Phone# ell# email: J 11. General Contractor:f0(12el�Zl C tdress � 2 �GC Q//QSe Phone# 9/Y-,=)71—zJS-74Ce11# email: 12. Estimated cost of construction $ (No)11 : I! udl include all labor,nuueriat,scaffolding.fixed edtepmcnt.profcssioual tees,and material and labor N�hich magi he donated Jails.� 13. Job Timetable: Start: Finish: (I1 6/1/2024 $UIL DIN G: FARTMENT r-= VILLAGE OF RYE AROOK Y 10573 OCT , 202 938 KING STREET RYE BRO©i�, V 914 939-0668 �� vv-ww xyg�M=kn3.gov P, 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: / `� 4 I, G4ell zc�� residing at, ASz '-t lI.clu2 s-�_ � J r�-�c. �V l�'y3 Hit OJIMt Jr�x. �ltctz vnu lip 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; �✓f �/ I' i� Z5t- . Il..-- &-ou Al y /b�X3 Rye Brook,NY. T i t„b A dd ""l Further that all statements contained herein are true, and that to the best of his/her knowledge and belief, that there are no]crown 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. Sworn to before me this C r day of V i t 20� `t #Iovz't�lm k0ow GREGORY M.RIVERA Notary Public,State of New York No.©I R16441398 -) Qualified in Westchester County Commission Expires September 26,2t 1(l 6,112024 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 YOM COUNTY OF WESTCHESTER ) as: _AZXA� IsS ,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 for the legal owner and is duly authorized to make and file this application. (indicate architect.contractor,went,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. Swom to before this Sworn to before me this day of=C ( day of , 20 .'ignatureof llrofertythvrier Signature of Applicant Z el, f10-1,3 Print Naine of Property Owner Print Nauic of Applicant, Notary POyc Notary Public GREGORY M.RIVERA Notary Public,State of New York No.01RI6441398 Qualified In Westchester County Commission Expires September 26,2 (4l 611/7024