Loading...
HomeMy WebLinkAboutPP25-048 Oo =n N = U4 r�I 00 7 M ti000 ►`� a J _ C A Cmo F. ir bn z 00 00 Ln z W 0c) � h z z W o p O vo I� ~ ` ' M 0:0, -t 14 z ^ � 00 U u Cs. ram- W 2 1� a w o � x WO cn H $ W a © W W a _ yE BR Bum E MENT MAR 31 2025 VIL E OF RYE K 938 KIN ET RYE B NY 10573 VILLAGE OF RYE BROOK (914)9 939-5801 BUILDING DEPARTMENT W h or PLUMBING PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: Q��o Approval Date: APR 1 Permit Fee: $ �ZD00 )6 Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, is hereby trade to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install d/or a ove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said in 'll be onformance with all applicable Federal,State, County and Local Codes. 1.Address: SBL: /��i J 3 ����Zone —/S 2.Proposed Work: 3.Property Owner: Addresss��&A-Y1 {� Phone#: Cell#: �!�/T_11")$�- 7 email: I 4+N" 4.Master Plumber: Address: Lic.#: Phone#: ell#: 91/r y" �—,W email: Company Name ddress: INDICATE F URES&LIN S O 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 1 st Floor 2nd Floor 3 Floor 41h Floor 51 Floor Exterior 5.*List Other Equipment/Provide Details: $ (Notarized Signatures Required Next 2 Pages) 4- 3/21/19 STn OF NPINORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (print line of individuals' iin as the pplicant) furthe stat 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 archit t ntractor,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. Sworn to before me this ` Sworn to before me this ?i::,� day of t2 �S-C 20 j day of Sim—t�ure of Property Owner r Si ature o ppli Print Name of Property Owner Print Name f Ap icant Notary PuJ&Rl MEULLO Notary Publii" Notary Public,State of New York 5�iARl MELILL0 No.01MM60063 Notary Public,State of New York Qualified In Westchester County No.01ME6160063 Commission Expires January 29.20 Z1 Qualified In Westchester County_ Commission Expires January 29,20 � This application must be properly completed in its entirety and must include the notarized signatures) 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. -2- 3/21/i 9 BUILD MENT D Vl E OF RY OK 938 Kilvc ET RYE B>iz NY 10573 MAR 31 2025 DD (914)9 9 39-5801 VILLAGE OF RYE BROOK w BUILDING DEPARTMENT 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: k C ����, -c vcL` vC�esiding at, v (Print name) (Address where you live) 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; &ne F�' . , 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, 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. (Signa I of Property Owneds)) (Print Name of Property Owners)) Sworn to before me this day of �'� G� C , 20 (Notate_ Public) SHARI MEULLO Notary Public,State of New York No.OIME6160063 Quallfled In Westchester County Commission Expires January 29.20 Z 3/21/19 * O 03 * v Qs- co co 00 CL * * td V ° . Q- � d w acsx ;.T, co as u 0-4 0.4 * * * UCZ a o o a Z ¢ a a a QyE BRC��. O�` tim cu � BUILDING DEPARTMENT ❑BUILDING INSPECTOR Q 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.or� - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: 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 }''NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER a � 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.or -- - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS: DATE: PERMIT# ISSUED: SECT: BLOCK: LOT: LOCATION: 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 ❑ NATURAL GAS ❑ L.P. GAS ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER 6—�1 BUILDING DEPARTNIF.NT VILLAGE OF RYE BROOK 938 KING STRFET.RYE BRoox,NY 10573 _ (914)939-0668•FAX (914)939.5801 •.......................... .........................4............................................♦... - Bl.t?F CARD CER'TIFICATION Wlls do,ument certifies th.tt :!uc natural gas piping work as pc.,waned in ac:ordancc with Rye Brook Plumbing Permit v:_L_ _ issued. -3 - is m compliance with the applicable sections of the Village of Rve IIrook& the NYSUFP&BC:.and has successfully passed the leakage test. Marc c•1 ID.. Property Owner: —G—Ar,,J� Je to l Dated: Plumber: I.ic. a: Dated: 7 " q ' Plumbing Contractor: '� � �ijt r i"} � ��S �•� % �`/— cl U(o" u y(, k Cl , G N l li 'I I1 {