HomeMy WebLinkAboutBP25-149 m
m
■
� N � ■
LO
[•� w lu x
1�1 � ce O
=
m i!i Q fsx7 it O. O W m
■ CAZ z � a. ■
M O A
i o
Ln
z cu F m
O E WW
W C
Q W � en 0D C g E a
`p cri F y G y G p mt
C
C a. I ■
^ .. P4 U44
d
cj C W W 4
W `"" 107,
x fY. w N 2 p L.L «0 w G E+ u m
2 0 a� O ( 1 4
GQ
�T0 V
en (�� L W uCN en
cn 'moo g� a y Q
00
j M 4
h1 p� pG O Cj n U w r
u OF
a W ti O
H
�+ a cr i CL
lud
F-4 p A y a m m
•. � O W W � � � a. v v a
0 � � � v � s
c
BUILD j WNT
Vu� of R oox
938 KING ET RYE BR NY 1057
4 _0, JUN 2 6 2025
ov _----1
VILLAGE OF RYE BROOK
INTERIOR BUILDING PERMIT APPL SPAR i MENT
FOR OFFICE USE ONLY: ���f
Approval Date: JUN U ��� / Application Fee:$
Approval Signature: Permit ees:$
Disapproved: Other: Leej
L�
Application dated: Z SJ is hereby made to the Building inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
interior alteration of an existinfi or for
/a change in use,as per detailed statement described below.1. Job Address: T 4y� �� "Y SBL: /35• / — —37
/Zone:
2. Proposed Improvem nt. Describe in detail): 'C
00 r. t 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 lI: 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: ✓ Yes:
(If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: I A ri After Construction: ^
6. N.Y State Construction Classification: N.Y.Staate Use Classification:
7. Property Owner: POL 1%G" S *% a&% Address: 1 T At'O + r 4
Phone# 9�y'�7� 'd )Cell# —W r(;4- email: f A f_g01"1gh
8. Applicant: A'o#% th t` Address: h s Z_
Phone# 9`1 C1 3 4C �!O� `Cell# —1 q 4(—0SZ;_4 email: A►C A
9. Architect:' Iy Address:
Phone# Cell# email:
10. Engineer: G) Address:
Phone# _ t Cell email:
11. General Contractor: I l r t OT Address: rOf Z•�S fi'><• �'we4 �' 7
Phone# x nj 7 -;In? CeIl# email: I% r 1 142
12. Estimated cost of construction
(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: �-`� Z Finish: �� Z
(1)
6/1t2024
BUILD MENT D LDi
VIL E OF R OOK JUN 2 b 2025
938 KING ET RYE BR ,NY 10573 t
-0 VILLAGE OF RYE EROOK
. ov 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 YORKJ COUNTY OF WESTCHESTER ) as:
I, EPMa"I ),O'"'l4, residing at go A
(Print name) a�,
(Address where��ou lice) �Q/�^ `����
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
4cab
to which this Affidavit of Compliance pertains at;
/r O Lq R
el Rye Brook,NY.
(Juh 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 i tration of any kind into the sanitary sewer from the subject property in accordance with all State,
County and lage Codes.
(Signal r•I ff Propert cncr(s))
.7 M .0 S_ CC, 41, L'
(Print Nameol'ProlicnN Owner(s))
Sworn to before me this
;,�tao
y JU o e
lRSAU MAS
R PUB
7E OF NEW YORK
196469
Public) Qualified in KINGS County
Commission Expires 11/171
(2)
6/1 r2024
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:
, being duly sworn,deposes and states that he/she is the applicant above named,
(print name 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.
S
worn this Sworn to before me this
, 20 day of , 20
Signa a er / Signature of Applicant
Prin ame of Property Owner Print Name of Applicant
NEVd yt�RK
6196469
otary Public R2gjglrStilOn MCING'r'(,O Notary Public
Qeatified Mn Ores 111171
Gomm`ssior��x
(4)
6/lnoz4
o
U
V1 Q 'n o ~ z0
� o o m z
o
W ~ ccO
> z
� w o
66JMM� O.r Q oZ
W o O Ocn
to - O i
o_
o
v c cc a
i
a O d G �
' U ` � z
Li
r - o
Cy,
00
cca
a a.. o m
- m
v m Q
c � Cl)
o c = w o
w o O
o ca Y
•� o
c c
m
— � �.
O
CL
A W
Cl � Z W
12
co
a W W oCLO
> W
x A
d , O
a) O
coo
w ` W O
A A
L
w o �
CL
H z F aL LL
o �
• � � o ai U U
V� U5o ~O o
I� 0 Y z z
w O � `om
O a) u
W — � 0 mo
z
W 'Co • W o
LU
� 0Z00
d �
�
Aa
>
3 a 111 t 0 (D
= w Uz
Z_ 'c
, 7
� cr
crw
� ca J
a v
M m
m = N
w o O W C--�3 J' CD
-o Z d
c N N
W
CLY
wo A d r as U75
r
a W
uj
�7
,
c`v Q
No z w
C7 .. U) m
w z \E v)
—
A w w (v 2 LL V > W
xA
`o EO h
` O
W o
�i coop� > � 0 z
E0 o
w �
° LLJ A
o J
O w L L
0 0a
L� -
A 0 z°
o �
• O ai U U
o = d j L Gr.
F A -p O U O
�' W OLco z
d
09
O G �
a 3
W _ u
xm cr, zz
� w � •� .= H < w
3 = Z o
w o
661
aL
>*
a, o
°' W -a c A.
O a) CA
p., 1 L -
aw
LL
00 — m c
p a
c ti = cl
>
M ~ m p m .
O
c) M Q
U
W O W CD
CA
o Q 04 Vi a. o
rZ w ac r
O W
oc
Q .
0
C1 [••I c> a W
V Z CL O �
L T
= w n m
A
��CLM
w
H
M ; w
m E m F~
LSO O
V] W N O "O
z
� 0Lu
Q
c
O v " � J
W 0CU
F z F