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BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573 MAY - 7 2025
(914)939-0668
N►ww-r ebr•ookn o`, VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
FOR OFFICE USE ONLY:
Approval Dare MAY 2 2 5t N Application#
Approval Signature;
ARCHITECTURAL REVIEW
BOARD;
Disapproved:
Date:
BOT Approval Date: Case#
Chairman:
PB Approval Date: Case#
Secretary:6"
ZBA Approval Date: Case#
Other:
Application Fee;> � Permit Fees:,&
FENCE / WALL / GATE PERMIT APPLICATION
Application dated: is hereby made to the Building inspector ofthe Villagey
for the installation,construction,repair or replacement of a Fence,Wall or Gate,in accordance with Section 2550 B.(1.N of the of the Vik ,for the issuance of ale a of
Rye Brook,as per detailed statement described below. Swimming pool fences must conform to the State Code. ( �(g),
1. Job Address: 6 R COO 0%& Do. j2_1/,E t3aC:C& N
I Occupancy/Use: P_4-E 'fp.L S.B.L.k 12-9,'1711 31 WCX 4 LOT 20
Zone:
3. Proposed Fence/Wall/Gate(describe in detail):
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4. Property Owner: 'BOO J2_l6o AP_E}k6 4pLL{;R
Address: $ GQ �I R �yE �17�00 k �y
Phone# 31i 7 7 0/-f 7 73? Cell# 6/1
7764 73 email: C p11
Applicant: l`ZODR1'Eaf0 krs p
Address: 68 COUNT—Y P l D E Da R-M BAWk. N
Phone# 47 _734 7 ?1 Cell #_ 3Zf7 7�"773,3 email: drl t01 k _
Architect/Engineer:
Address:
Phone# Cell #
Contractor: // email:
Lf l p/P!S Q — le c 7QJ
Address&Phone: P r7
5. If building is located on a corner lot,which street does it front on:
6. What is the estimated cost of construction
(NOTE:The estimated cost shall include all site improvements,labor,material,scaffolding,fixed equipment,professional fees,and
material and labor which may be donated gratis.)
7. Estimated date of completion:
t
611i2024
Please note that this application must include the notarized signature(s) of the legal owner(s)
of the above-mentioned property, in the space provided below. Any application not bearing
the legal property owner's notarized signature(s) shall be deemed null and void, and will be
returned to the applicant.
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as;
(print name of individual signing as the applicant) being duly sworn, deposes and states that he/she is the applicant above named,
and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
(indicate arehilee;l,contractor,agent,attorney,e(c.) for the legal owner and is duly authorized to make and file this application.
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 l Swom to before me this
day of , 20 day of , 20
SignaturV f Property Owner Signature of Applicant
Rriq Name oT Property Own Print Name of Applicant
Now' @ic Notary Public
SHARI MEULLo
Notary public,State of New York
No.01ME6160063
Qualified in westchester Count
Commission Expires JanUary 29 2"_
2
6/1/2024