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HomeMy WebLinkAboutMP25-048 14 y w O N N 'a fq O C W Q1 N � MO m i _ W � z w Q z �° � H © L d s v u ate+ tu «. a ° .2 c H � o (U ° a �+ cn ten � o w a ,o W1� 's F� -i ,� CA w U W w - F—� �'1 © F„i P� (� [r � � � ai rn cam• @ W s F—� H o C pe. 0 x U w a 0 V1 O CAW © ac z 1�6 ICU) � V ct) o . 8 Z I o a o M � � V z A z A o � � ° o O � d o � � -, BUILD MENT E 1 'L D VIL OF RY 1OK 938 KING ET RYE BR ,NY 10573 MAR 26 2025 Q 4 9 �.. . ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITION,I�NG EQUIPMENT FOR OFFICE USE ONLY: PERMIT#: r%' � Q Approval Date: Permit Fee: $ C� Approval Signature: Other: Disapproved: (fees are non-rel'undable) 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 REOUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed& Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder)&Workers Compensation Insurance on a NYS Board form(Form#C105.2 or Form#U26.3/or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit: RESIDENTIAL =$150.00/unit • COMMERCIAL= S450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required) 7. Electrical work requires a separate Electrical Permit&Electrical Inspection. 8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection. Application dated,'3 c)"T is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County, State&Federal laws, codes,rules and regulations. 1. Address: a Ctln(Cn d P.I? Lur - R,-ie itir oe- t44 les-I S SBL:/�/lq`1+1—sz) Zone: —f 2. Property Owner: AvrWtalu AuSAtA Address: 'd wmo d eKatt, r2m41(uiaow N4 lose Phone I It6i'61"i-co5�t Cell#: email: 3. Contractor: kssaeu ks kkC, Address: ?YI FtkaS kL4tr. 0ot'1 S%km ak to54sc Phone#:cJW-xt(.9- etoo Cell#: email: (ofy% 4. Scope of Work:New Installation( ) •Replacement{✓�•Removal( )•Other( ): 5. List Equipment: 1TVt1J C 6e=YAC � _ LAC � 6. Location of Equipment: P,l AQ 7. Method of Installation/Removal(list all equipment needed to perform job): 1 6/112024 /10/2025 3 : 44 PM FROM: Staples TO : +19142760300 P. 2 Fro i n: Lyndsey aelVecchio jbjec:t: Permit Authorization Date: Mar 7, 2025 at 1.'05:51 PM 1.0: ajaus@optonline.net C;,: Anna Saries 1'k ,Il, :c ;_.l Good afternoon, I am gathering the paperwork for the permit for your upcoming replacement. I have attached the authorization form, if you could please sign, get notarized and send back to me that would be great. Thank you so much, Lyndsey (P) (914) 276-0100 (F) (914) 276-0300 \,yw4v.airpro s.com 1?ttps_'/WIa N,.��:faccl)ook.c(-)iii AirPro Assoc MRAJUH� AIR PROFESSIONAL ASSOCIATES, LLC 39 Fields Lane • North Salem,NY 10560 S TE OF NEW YOR OOI TY Of W1 STC HGSTP.R ) as: v �ti// It _;_rt being duly sworn,deposes and states that he/she is the applicant above named, (print xme of indtdsfJt signing AS I}Ie Applicam) and further states that(s)hc is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. 'fhat 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 lire Prevention&Building Code,the Code of the Village of Rye©rook and all other applicable laws,ordinances and rcgulations. Sworn to e e me this Sworn to before me this j l 3, clay of T,20�4 day of I�ARGS! ,20___A-5 __ Signature of property Owner Si t ure f A- licant �- ► a h Au .5 - Prin Na of Pro erty Owne Print Name of Applicant Nota E B. VE SPA Notary Public Notary Public, State of New York No. 01 VE50B402E1 CARLO NERO Qualified in Westchester Count )MARY PUBLIC,STATEOF NEW YORX Commission Expires August 25,20 t Registration No.OINE617%90 Qualified in WESTCHESTER Coady Cmmbsioa Etta 02-04-2026