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HomeMy WebLinkAboutPP25-104 e a � � N ® O cq L N tn Ao = N \ W W s ■ PO oG © ICI ■ z W u C� ■ � a e (� x � © ■ : w Cl) r+y�lj .� a� 1�•1 ■ I� T-4In � F-� � w � Fyl ■ en o Z o a oa Q o W o 04 w ° O z Z z o = w �i p w U pp 00 1-4 ■ �I W w f-, o w ° V _ z o � z v uz z z z r--+ cn OCSN cn � M V Cf) cy Re w U zz 64 04 w O O ° F. ?� c p z � cn U � V © I� N c+ Qr I r A xLn _ BUILDING DEPARTMENT © � VILLAGE OF RYE BROOK JUN 2 5 2025 938 KING STRFET RYE BROOK,NY 10573 (714)939-0669 VILLAGE OF RYE BROOK W\VXV.r cbrookny.gov BUILDING DEPARTMENT PLUMBING PERMIT ATION FOR OFFICE USE ONLY BP#: PP #: Approval Date: Permit Fee: $ t�o Approval Signature: 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 CON1PLL"TLD WITHOUT A PERMIT IS 12%OF"THE TO'!°.1L COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated, J is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformance with all applicable Federal,State,County and Local Codes. 1.Address: E5 _ZM1 a --_SBL:Lc)9" &0—1-- Zone: 2.Proposed Work: t_ul &A6i cko S Caok-D_ II , J- 3.Property Owner: A(y-' I �2QA)kt tJ Address: S Phone#: H 3 Z)\I►14 l la 3 Cell#: _email: M A)t P-6 '76 Gq",A-, !- tom Ai lk' 4.Master ppPlumber: i (L SS i _Address:4a� � s'a uj(— CA�eA Ay A5)�» Lic.#: O4 1 Phone#:345 �95-2,-Ma Cell email:Sc r0CjL LP CASs;d:y ovotAqiAt.m. Company Name&S I��t�p�u (a rya r A�CL2� Address: 4;.) OAR AA-t l L-N IL INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath. Laundry Domestic Fire Sanitary NaturaU Other* Tota[ Closets Fountains Pubs Tubs Service Service Sewer LP Gas 1 I Basement i I st Floor r 2nd Floor 31d Floor 41h Floor j 5'h Floor Exterior 5.*List Other Equipment/Provide Details: (Notarized Signatures Required Next 2 Pages) -1- b/1!2024 ST�TE 01- NE YORK,COUNTY OF WESTC;HESTE R y A� _ ,being duly sworn,delx)ses and states that he/she is the applicant above named, !prim mmeofindicidua!signin ac�Hr et licent) rind further states that(s)hc i%the Master Plumber for the legal owner and iK duly authorized to make and file this application. That all statements contained herein are true 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 conformance with the details as mt forth and contained in this application and in any accompanying approved plans and specifications,as well us in accordance with the New York State tlnifonn Fire PrevtVmion&Building Code,the Code of the Village ui'Rye Brook tmd all other applicable laws.ordinances and regulations. Sworn to before me this Sworn to betore me this day of Q6112 .20 Clay of Signature Property Owner _ Signature of icant� � MAX, (AkeqT'j,j s.Sor. Print Name of Property Owner Print Name of Applicant Notary Publi N wry I TINA TE SA A GRISTINA NQr RY PUBLIC-STATE OF NEW YORK NOTARY PUBLIC-STATE OF NEW YORK No.01 GR6438779 No.01 GR6438779 Qualified in Putnam County Qualified in Putnam County qq My Commission Expires 08-22-2026 1'hi tt llip'�'t' fP io4pt'rge prop rly completed in its entirely and must include they notarized sit:nature(s)of die legal owner(s)of fire subject property.and-the applicant of record in the apaccs prow-idcd.Applications ttat properly completed in its;emirety an&,car not properly signed small be deen-w-d dull %ad void and will be retumcd to the applicant. b/l/2024 a WE JUN 2 5 2025] VILLAGE OF RYE BROOK B1111WIPM 6"ARTMENT TBUILDING DEPARTMENT Viu—AGE QF RYl ',SRom 9311 loaf;S�su yr Kt'y Hmxw.NV 10573 t�rtttatt;ttt�ittY#ttNtt�,lat�rttrrt•rtrrirttRs4At•►sr♦�Arw��rtiw�r•6�����wwlitryiwf4iH♦rr+a♦ewlwtwtsttr AFFIDAVIT OF COMPLIANCE VILLACA CoDr, 4216 STORM SI.WURS AzNr)SAMT-�kY SF:�vF:Rti Ttiis APYtOAVIt' MUST X#.Alt Tk8 XtnAR12RL' 41,;MATURK Or TdA ).ZWl ""CATY CWHr-H A?1W AN SX1R"I2iEV AL)M; U$TH ANY E.IUY.L�.TIM OR PLU"I NO DEPA1T' APPLICAT100- �JtT OUIL,olzr' op pIaA�l UG pY,A7lI3 APP ICAT'YQY SUSI1TTED MITg{WUT T'112$ CC*WLrr.Wa AM WyrAtklZtD rtWX#'" Be lit TUPlab ""r:� THX APPLICANT STATE OF NE W YORK.COUNTY OF WESTCHESTER ) as ,�C I,� A. MCA . �� r�i��1�V .. . residing at_�..1...G�.Lr�1c'.'.[E._' _� ,�- ---.' being drily swum.dcposes and states that{slhe is the applicant above namcd.sad further states that(s)hc is the legal owner of the property to which this AlTd svit of Comphancc pertau..at, Rye 8 FyY AI Further that all statctrlents contained herein are tnte,an that to the heal of hisfh*,T krtowlc'dge and belief,that there am-no known illegal cross-eonnsctton►s concerning,either the storm"'wer ter san'tary+sewcr.:uad further that ihcre arc no roof drains, sump pumps,or Other prohibited stormw'ater or groun4water connt:ctions ar ukurc of inflow or infiltration of any kinct into tfa:sanitary acwcr from the suhicet pro ntv to accordance with all Statc. County and Village Codes. �rui'°.N:kr.1 t';,-:'i�tJK�•a••,,4, Sworn to befurc me this day of r Jy1n _ _W 24 a 7 TER SA A GRISTINA NOTARY PU130C-STATE OF NEW YORK No.01Gft438779 Qualified in Putnam County My Commission Expires 08-22-2026 ��ye BRO o �m cu � 1982 BUILDING DEPARTMENT ❑ ILDING 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.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - ADDRESS : te, DATE: b - Z 7 ' OoZS� PERMIT#�P 2S� O ISSUED:b Z�_ZrSECT: IZ'i. LL) BLOCK:_I 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 GA A Pe �r �.� t c 00 L- L.P ❑ L.P. GAS / . D n /- ❑ FUEL TANK - (�-A lCt w) �'�` C'J C6 C lu G ❑ FIRE SPRINKLER FINAL PLUMBING ❑ CROSS CONNECTION ❑ FINAL ❑ OTHER