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BUILDING ]!ARTMENT 12 E GC 1_� ld �'J I
VIL6A OF R OOK A — 7 D'
938 K NG�ET RYE BR66k,NY 10573
MAR 2 5 2025
WW:, 4,
W L ov VILLAGE OF RYE BROOK
BUILDING PEPARTMENT
INTERIOR BUILDING PERMIT APPLICATION
FOR OFFICE USE ONLY:
Approval Date: APR 0 ertnil# / �-�' _0& � Application Fee:$ /00 /""1b --
Approval Signature: Permit Fees:S l U
Disapproved: Other:
Application dated: 3121/2025 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
interior alteration of an existing building,or for a change in use,as per detailed statement described below. Q 7/
1. Job Address: 48 Valley Terrace SBL: ���� �/--/"`, ,3 Zone:
2. Proposed Improvement.(Describe in detail): Interior bathroom renovation.- M Q-O<,:v{
t r] -CICAL-
MoT:>ivicA-Tio,\Js. t\I.a a� TI t.tl C�1�S T+t rz ram-►�-1�y T .
3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook?
No: x 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,ANSL System,FM-200 System,Type I Hood,etc...):No: x Yes:
(I please submit a separate Automatic Fire Suppression System Permit application& 2 .o,A'detailed engineered plans)
5. Occupancy;(I fain 2 fain.,comm.,etc...)Prior to Construction: 1 Family After Construction: 1 Family
6. N.Y State Construction Classification: N.Y.State Use Classification:
7. Property Owner. won K.Ryan Address: 48 Valley Terraos,Rye Brook,NY 10573
Phone# Cell# 914.924.2381 email: BKEANERYANOGMAIL.COM
8. Applicant: Burton K.Ryan _ _ Address: 48 Valley Terrace,Rye Brook,NY 10573
Phone# Cell# 914.924.2381 email: BKEANERYANOGMAILCOM
9. Architect: N/A Address:
Phone# Cell# email:
10. Engineer: N/A Address:
Phone# Cell# email:
11. General Contractor.A&S Renovation&Painting,LLC Address: 3 Drake Ave.,New Rochelle,NY 10801
Phone#914.979.6159 Cell# email:
12. Estimated cost of construction $ 10,000
(NOTF The estimated cost shall include A lalxir,material,scaffolding,faced equipment,professional fees,and matenal and labor wbich maybe donated
gratis.)
13. Job Timetable: Start: 3r3l/2025 Finish: 4+312025
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BUILDJ _�> R 'MENT n �� l
VIL R4 E OF 11 I �+OOK V
938 KMG NiET RYE BROcJk,NY 10573 MAR 25 2025
4�4� 046$
�oe ov VILLAGE OF RYE BROOK
BUILDING PEPARTN,1ENT
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:
I, Burton K. Ryan ,residing at, 48 Valley Terrace, Rye Brook,NY 10573
(Print namc) (Address where you li%c)
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;
48 Valley Terrace, Rye Brook, NY 10573 Rye Brook,NY.
(Job Address)
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, sunup 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.
ofii_�
(Si alur ol'Prnperh O�%ner(s))
Burton K. Ryan
(Print Narne of Property Owner(s))
Sworn to before me this 21 st
dav of March 20 25
( Can-Public)
BURT014 THOMAS R"AN, JR
Noiary Public, State of New York
ork
No. Cr2,RY0297994 (2)
Westch.ester County
Term Expires 03/03,120
6/1/2024
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 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 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.
S�
Sworn to before me this 21st Swoin to before me this
day of March 520205 day of Ata ,20�_
Alza4t'_
Si of Prop"Owner S' o licant
Burton K.13 an .
Name of Property wncr ame of Applicant
No Public N Pub r,
i TON THOFAA Ya',�v,
S"�Ft i ON T}I®�,1/;S R Notary Public, Slate tJr.w Yor
NotaryP 1H No. 02PIY62�.
Public, Slog Of New York
o. 02, 1 f9' 94 Vb'estc! vsCer Count
Weslc,'Ia.�, C' Tprn :y C
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