Loading...
HomeMy WebLinkAboutMP25-074 O � x - �i N N � "v � �••' x ^ 00 v I1 N CV 11 y ~j \' in � ryr y F� ae C 00 a ro o "a as - 1.4 - " ;T4� o �4 -0 v o �nco 'o z OL�J �f'--y A a y o © let '° O I—I 0 Fif C 'd f' 0 _ O woo w 3 °� ° C) Q O �..� U v ZO •zs v Q C3 U W a x d o Q 'a _ N CO, • aCo 00 CIS U � M b = �4 t y N V UOEM CA F-+ 0 x V u Tt o 103 = H � � � O W off �,� •� �I as a a a w x � � � � •� s a S BUILD MENT Q ' P VM OF RY OOK j AY 2 8 2025 938 KING ET RYE BR NY 10573 4 VILLAGE OF RYE BROOK . ov BUILDING nFpARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING, VENTILATION AND/OR AIR CONDITIONING EO UUIPMENT FOR OFFICE USE ONLY: PERMIT �0 Approval Date: 50' Z,)- Z a Z s Permit Fee: S '-/0,6 Approval Signature: Other: Disapproved: (fees are non-refundable) 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 I2% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 REQUIREMENTS FOR RELEASE_ OF PERMIT&CERTEFICATE 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=SLsfi nn._ /_ U L-COMMERCIAL =$450.00/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, s 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. ryEagaY, NY 1. Address: 44 Cnuutty twof DaAmC , 17313 SBL: /ot9•S9'- ��/� Zone: yY cevmrwy It1vefte Pit, 2. Property Owner: SUC9145 5TVAQ-r WVA9LM Address: Aff Jg=Xd A) IaVa a Phone#: I-f- 14 Cell#: email: WELMSUERF �, t r(p71h 3. Contractor:JEW ME(R-NlCH1,I 1 �! Address: ae Phone#: In-bda- &m4 Cell#: email: CbUZEMQ4&EJJ MELk{ [ACM 4. Scope of Work: New Installation{ ) • Removal O.Other( ): 5. List Equipment: Al 1AgNJDt g., CbNDE AIS9V- krZ 1?PSTR-IR-5 4"C0to NELT 0Ct5T W_4 RIPw tw l pLyurw61 A-L 6. Location of Equipment:�-y 7. Method of Installation/Removal(list all equipment needed to perform job): MAN Porn& ! A a ND Tg>uo(-1. 1 611/2024 STATE OF NEW YOM COUNTY OF WESTCHESTER being duly swom deposes and states that he/she is the applicant above named, (print name of individual signing m the&Mien) and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. That all statements contained herein are we to the hest of his/her knowledge and belief,and that any work performed.or use conducted at the above captioned property will be in conformaocc with the details as set forth and contained in this application and in any accompanying approved pleas and specifications,as well as in accordance with the New York State Uniform Fin Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Swom to before me this Sworn to before me this �p day of 20_2:.� _ day of Mul20 _ l , ! Signature of Applicant S gnattrre of Property Owner ' -- t Nam of Property Owner Print Name of Applicant Notary ppu�b�l��� tary Public ISHw MEULLO Notary Public,State of New York No.0IME6160063 Karlieann M Siciliano Qualified in Westchester County ✓/>r Ito fhr y Commission Expires}enuary 29,20 WSJ^-eu+�s /W!wrap wur c�a4►ts.rt],} 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 provide(-Any application not properly completed in its entirety itndlor not properly signed shall be deemed null and void and will be returned to the applicant.