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HomeMy WebLinkAboutBP25-130 6 x N eq C 'd v f N s N eq WN a 04 r M N p a p s Z o O 3 cy0i Q © x � d r�!/A LO 91. F O O u .g� E >1 bA Vf'iIJ H C) _ O E C O U `n w' .-• rn d o O RCS. mo 0 y PSI 00 � A • W1 � 0 ig O W C) Z ono i d� z ° Q -� `= � Uz rf) C� oo �' w v Q Z 00 19 cy e O 5 ,0 Q. M+w Oz r', d U y3y v A w z z 4 O � o � f f BUILDING DgARfMENT VILLAGE OF%RO E OOK MAY 2 8 2025 938 KING STREET Rv `l NY 10573 4�� -O, VILLAGE OF RYE BROOK w ov BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Approval Date: n ( I r t c� J/ � plication Fee:$ /00 Approval Signature: Permit Fees:$ Disapproved: Other: Application dated: S712,112A is hereby made to the Building Inspectorof the Village of Rye Brook,NY,for the issuance of Permit forthe interior alteration of a t exi ting building,or for a��change in use,as per detailed statement described below. 1. Job Address: 21 Dcoa o - 2y2.,ze 5 AL VJ&C! SBL: /c�9+ D6 I-J36Zone: 2. Proposed Improvement.(Describe in detail):_T/2,,SS D "+/L +y,r r ,s`nn� x1P+� 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 11: 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 1 Hood,etc...) :No: /Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy•(1 f—)2 fan.,comm.,etc...)Prior to Construction: / 6%-, After Construction: ' "�- 6. N.Y State Construction Classification: / N.Y.State Use Classification: -Q: - 7. Property Owner: ,1/IfQ� `Z • L Address: '2� D!Djaj ��f OX uVef-' Phone# ! Cell# /5/- _6Z -3 oS0 email: 8. Applicant: 6kle1-N Address: Phone# E ;3&_dM Cell# email: &�� - 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: ,% §V&A0(bm2 N.11 PA �p, g �e cl, Phone# 'l N- "�F - y I q_'S Cell# n—email: �� �/ I1. General Contractor. -S Ct1J �C- Address: gi/ ilzeAsk,if ��wA.'A. ULJ/ m Phone# Cell# —email: � u/C�T c���//f71C� Sit A11 C'.-1 12. Estimated cost of construction $ (NOTE:I'he estimated cost shall include all labor,materia(,scatfolding.fixer[equipment,professional tees.and material and labor which maybe donated gratis.) 13. Job Timetable: Start: Finish: (I) \ v 6/1=4 D W1-L� BUiLDjNCi DEPARTMENT � MAY Z 8 DD 2Q2� VILLAGE,OF RYE BROOK 938 KING STREET RVE BRt)oIC,NY 10573 VILLAGE OF RYE BROOK (914)939-0668 BUILDING DEPARTMENT ww�ur.rvrilit>rc3.e[t� •ii#iiiii*iiiii i*i*#A****Ai ii AA*iii*iiii*i**iAii##*i#*iii A#iii iiikA*#**ii kt iAiii*iii#*4#ii iii liii*ii*iA AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AIFIDAVIT WJ9T BE" THE l"ARIitli SICHATLIR.[ :F' THE LEGAL PWPERTY Cr MF( AI'C BT SUMITTtII AL,UMG WITH ANY BUILDING GR PIAMING PIMIT APPL CA;ION. ANY BUILDIWC Cm ;1LUl0INC F134MIT APPLICATION SUBMITTID WTTHOUT THIS C011PUCTXU AND WJTAXIZ[X• r-,"j WILL at RX1111 ttD TM THE APPL.'C_WT - STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 1, hrj111yWVb 8. djt1`rC LL- ,residing at, S 1)(2"466 �� d N /3r 0XU"'5 W IPrim r.u::.. Tv1dr.:+•nh:rr}nu Inc 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; t;7 fir: WC5t" Rye Brook. NY. IL11,Addlc—1 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. f ISifn.ntor ul I'n�pavty Oerlerhll TA1CCIZ 1�4-4Ac.,J6 �f. r�lc�vlFl�y �xecv 1�,� i(•-n,\a+n:nl t`n ry+rn� rh�rK•n11 Sworn to before me this y / day of 20(f4 S 1',olan Leanne M.Freda NOTARY PLBLIC.STATE OF NEW PORK (2) Registration No.02FR4M6796 Qualified in Westchester County 6'IR02A Commission Expires Fcbruarn 1?.:027 1 This application must be properly completed In its entirety and must include the notarized signature(s) of the legal owners) of the subject property, and the applicant of record in the spaces provided. Any application not properly completed in its entirety andfor not properly signed shall tx! deemed null and void and will be returned to the applicant. Please note that application fees are non-rofundahle. STATE OF NE W YORK.C'OWFY OF WLSTCHESTER f as: 96y �_M_ JDL 4t~0— being dul) s%�orn.deposes and states that he she is the applicant above named. (prim name of indmdwel%igning a%the apphcantI and further states that (s)hc is the legal owner of the properiy to %%hich this application pertains. or that (s)he is the _9XCC4TU R. _ —_ for the legal owner and is duly authorized to make and file this application. 111'4 ,:tc atchttcct.amnactw,agcnl,allulnev eu I That all statements contained herein are true to the best of his her knowledge and belief.and that any a ork performed, or use conducted at the above captioned property u ill be in conformance with the details as set forth and contained in this application and in am accompanying approved plans and specifications,as.veil as in accordance tiff ith the Ne%% York State Uniform Fire Pre.ention a& Building Code,the Code of die Village of Rye Brook and ail other applicable la►s-s,ordinances and regulations, By signing this application,the property owner further declares that he she has inspected the subject property,and that it) the best of his:her knot%ledge there are no roof drains,sump pumps or other prohibited stormwater or groundwater connections or sources of infiltration into the sanitary w%ker system on or from the subject property. Swom to before me this d 7 Sworn to before me this day of r '' 24 5 day of 2 StgrwRur u(Prt�pertx fMncr \� : Wit E-•i' TE OF FAA14C-IAI L,il'iAXC:r ttMi7 t�lyMar4b M • I--1LA lEL,!r. EXEC. ( Pr�ta IN'atne n, Pcrtfi thtiner lameui.\t pl. .u.711 Mxan Public do 3 4 Nhhc Leanne M.Freda NOTARY PUBLIC,STATE OF NEWYORK Valerie N Ferrara Registrntioa No.02FR4$85796 (l-hfied in WestchesterCounry Notary Public, State of New York Commission Expires February17.2027 Reg, No. 01FE6366324 Qualified in Dutchess County Commission Expires 12/0412025