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BP25-106
N � N W U x ^^ rl cr a , FMMB[ \ \ �] h+�l Le7Ln u7 5 s x (T 55 sa rA OrCA , on td d° u (3� en b a Q W hoc rn ° o W s 04 , O u y O x �s p o O V N w o � , = e o a� 0, C4 ow t1 x W `.1 N i cC�" "a v ►� x W 1'i y 'y e�6 Q s Ln Z + zowati° E V = Z � O 3 ;a z U Z �' ti a c `n = ~ � I OON � CG � ,• o iZ ou Q u yo o � m � U W . Z wz � � � � � � x O o � �° p Id x O I-� Q z r �, cn© W W w H O w © Z v ,, ,, � v W W t H ►.� zWz Q V, Q O t� oaZ a� C�7 o ul O O s 0 tp�G avi a+ 1i Q O C v 'v as a W w x � E � 4 ,0 a e BUILD MENT ® IE Q IE N V IE VIL E OF RY OOK 938 KING ETRYE BR ,NY 10573 MAR 18 2025 4 _0 -s ov VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: MAY 1 Z 20 Pe 't#: Application Fee:$_/ "f AJ Approval Signature: Permit Fees.$ &3o—toe— Disapproved: Other: � r �'/-- \%Z-JLcti% _10- Application dated: is hereby made to the Building Inspectorof the Village of Rye Brook,NY,for the issuance of Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: ff7 SBL: 1'55- Y1 "l -53 Zone: (Z- 2. Proposed Improvement.(Describe in detail): -. I�� '� '` ° T►rtslr\ed . can aF Y-L-16-en -9 tr ex,r►.� u i. ► �'` Cz .'^ 6 Pllmi 4(4ar� 6ZapL �k- A3 t4- C...ua.S . 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,ANSL System,FM-200 System,Type I Hood,etc...) :No:_L,-'� Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: I FD4w1 l-1 After Construction: 6. N.Y State Construction Classification: N.Y. State Use Classification: 8'Z 7. Property Owner: 3&\h Co r ��C r acs- l - Address: 33 3�jr*,-+, 'tllk rLo Phone# l-4 Z.7 3- -735' Cell# q ly 7) 4- wSZ email: rnal[,C'Pi 8. Applicant: /d� Address: Phone# Cell# email: 9. Architect,-_Y&i► C, C cx,r 1� - 1k"44' dress: 3 rccr►• tl ItO n►t_ /6S-`44 Phone# (I /Jr) Z73- 73-5-t> Cell# `f/,4 email: GS�,arlo,-� �GI�'t•/LCt� 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: Address: Phone# Cell# email: 12. Estimated cost of construction $ SJ " (NOTE:The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: (I} 6/112024 BUILD MENT RMAR IE C IE �WVIL E OF RY OOK 938 KING ET RYE BR ,NY 10573 18 2025 DD 4 -0 w ov VILLAGE OF RYE BROOK 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: G Sew tc A4 . , residing at, 33��r, I1 Iz0, a�IC, I� (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; .5-7 Vck �Q j —1-err t Q_, , 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. I � (Sig atur I'Property Owner(s)) (Print Nance of Property Owner(s)) Sworn to before me this 1 day of V\ Ca r r, , 20 a AL, V\Lj_�z (Notary Public SHARI MEULLO Notary Public,State of New York No.01ME6160063 Qualified in Westchester County. Commission Expires Jandary 29,220 (2) 6/1/2024 This form must be properly completed¬arized by the Design Professional of record and the Property Owner. Failure to provide this completed-form with your. permit application will delay the permitting prod R IE U I M W IE MAR 18 202,] 3D Notice of Utilization of Truss Type, Pre-Engineered WftNGE OF RYE BROOK or Timber Frame Construction. (Title 19 Part 1264& 1265 qy8kftD1NG DEPARTMENT To: The Building Inspector of the Village of Rye Brook. From: '3 c-Z_ G , t o..-'t0 �- art-c t-l� c.T Sub 0 ect Property: 17 r% YCAO-" —� SBL:)_V..59 _ l ,-53 Zone: —� Please take notice that the subject. or Two Family; ❑ Commercial, ❑ New Structure ci .Addition to an Existing Structure y kehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; ❑ Truss Type Construction (TT) ❑ Pre-Engineered Wood Construction(PW) ❑ Timber Construction(TC) in the following location(s); ❑ Floor Framing, including Girders&Beams(F) ❑ Roof Framing(R) ❑ Floor Framing and Roof Framing(FR) Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR §1264 for Commercial Buildings, and NYCRR§1265 for One&Two Family Dwellings. Sworn to before me this Sworn to before me this day of (`M OL(o ,20 , day of 20,b S: gnature of Property Owner �gnaturc_ofsign Professional zzin G 5C1v,I o d�c SHARI MEULLO �h7 G SCa•_A� -?'L Name of Prope r Notary Public,State of New York 75a ame ofDesign Pr a sio 1No.o1ME6160063 Quallfled In Westchester CountyNotary Public Commisslon fxplreslantlary 29,20Z 7 Public (3) 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: vN G Scxtr'1 _ 5 ;'`being duly sworn,deposes and states that he/she is the applicant above named, (print nanne 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. Sworn to before me this 1 Sworn to before me this ` day of a t G� , 20 day of f _�OL l G �N , 20�� rgnature of Property er ignature of Applicant n t; st�ai l-4% ---7L JPhh G Print Narne of Property Owner SHARI MELILLO Print L4arne of Applicant 1a Notary Public,State of New York Na.01ME6160063 Qualified In Westchester County. Notary Public Commission Expires lantlaty 29,20� Notary Public (4) 6/I/2024