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HomeMy WebLinkAboutBP25-155 : N \ eq [ a O"99 C, O W = rat FF—/I = O ' ./( � Ln oo z v °0c H _ � � � O O W w O0 � o � � a.•.. � , CN M � p �_ C\ F--1 el O O -� cti O s 00 00 ZO © 4-8 � �..i Q1 _ uopa CID 00 n W H oE Q Cl) a o14 � � � o � H : U ' W F' Oo 3 z � Q x � 2 I+I U U U z w a C7 A z W O L7 = BUILDING DEPARTMENT D ECENE 3D VILLAGE OF RYE BROOK JUN 1 8 2025 938 KING STREET RYE BROOK,NY 10573 (914) 0668 VILLAGE OF RYE BROOK wvt ?rti {� yQv BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: ,,��--^^��nnA /� Approval Date: P mi #: � / ''p.pplication Fee:$^ i,/l..'' 6 Approval Signature: Permit Fees:$ / o 0 —b o e_ Disapproved: Other: Application dated: fY�U 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 existing bui ing,or for a change in use as per detailed statement described below. 1. Job Address: M kreel^ /e ��ft�k" A/ SBL:/3S1 7�/ �`1 Sr//Zone: 2, -)Proposed Improvement.(Describe in detail): S��w✓� tTA . IfW :Vd ,;e` 8 oQ f uJe +IEr ' y jv yl/ rx/�i7�► ✓ O-V 1 �IDI'L u/�i A/tw/ 1 EhCG449 LvAJ_4im4&wWr 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 It: 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 Pe it application&2 sets of detailed engine red plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: �NG I-ZY After Construction: 19Ate M 4 6. NX State Construction Classification: N.Y.State Use Clajsssiif_icaf n: )Property Owner: 6 , Q✓ Address: 2 t"�' r AJ Phone# Cell# Ac email: 76A 717 d_ O I T Y yc i — cT 8. Applicant: $5 1 Address: ►C� Phone# / Cell# / - O email: qC a tom i A) 0✓ ✓� 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# orn Cell# email: QD1. General Contractor: gw' "Afess: G J Qf� �e1 " �e C r c'r Phone# Cell# fq111 - 0W email: N%� - stimated cost of construction $ 9-/- 75V X TE.The estimated cost shall include all labor, erial,scaffolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: 7,�Ale_ Finish: (1) 6/l/2024 BUILD MENT R VtL E OF RY OOK J U N 18 2025 938 DING ET RYE BR ,NY 10573 `'( _ 4 -0 VILLAGE OF RYE BROOK w t ON' 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 . New yowk. STATE OF N,EEW YORK,COUNTY OF R ) as: I, `/z w 14 e�i ,residing at, 12 A_j �«�l �r.V L (Print name) (Address wh re you Live) 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 A a tpr%mot , Rye Brook,NY. (Job 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 infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signature of Property.Owner(s)) p4nrc 1 (Print Name or Property Owner(s)) Sworn to before me this o 6 day of T..n c 920 5- 1t4W627 (Notary ublic) SUZANA MUAT + Notary PubHe•State of New York No.01M6177520 Quam w In aum m Courtly (2) Conmb*n Fxom it-n2027 61112024 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. NttN Yo dlc STATE OF EW YORK,COUNTY OF ) as: _ E�+^ic/ J ,being duly sworn,deposes and states tha�&he 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. Sworn to before me this !b Sworn to be re me this day of 14 n C. , 2025 day , 20 � ..�_ --_ AA- Signature of Property Owner idFint Print Name of Property Owner Pr eofApplicant nt !4 !�-�s Notary PAblic Notary_Public SHARI MELILLO Notary Public,state of New York SUZANA MW No.01ME6160063 NftYPubMe•&AMOfMrwYork Qualified In Westchester County ��ti1Or,+•rr"00 Commission Expires January 29.2l L_l w OWA*Mrr Egrw 1"06W (4) 6/1/2024