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BUILDING DEPARTMENTFVILLAGE
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lo
VILLAGE OF RYE BROOK
(`� y� Lam'
938 KING STREET RYE BROOK,NY 10573 l
(914)939-0668 UG 1 1 2025
isµw.rvebr�►oknv.>lov OFRYAr;CQK
N(7-, DF
ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION
FOR EXTERIOR WORK WHICH DOES NOT REQUIRE VILLAGE 49041TECTURAL REVIEW BOARD APPROVAL
FOR OFFICE USE ONLY: X'
APPROVAL DATE: - PERMIT r UAPPLICATION FEE:ticX
APPROVAL SIGNATURE: PERMIT FEES: ��~
H.O.A.APPROVAL: DATE:
DISAPPROVED: OTHER:
Application dated: 07/28/2025 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance ofa Permit for the
construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below.
I. Job Address: 15 Hillcrest Avenue, Rye Brook, NY 10573
2. Parcel iD#: 135.76-1-62 Zone:__
3. Proposed Improvement(Describe in detail):
Installation of ( 16 ) replacement Andersen Acclaim Windows into existing openings with no
structural alterations.
4. Property owner: Lisa Marciano
Address: 15 Hillcrest Avenue, Rye Brook, NY 10573
Phone# (914)939-1748 Cell# e-mail llsaseveromarciano@gmail.com
List All Other Properties Owned in Rye Brook:
Applicant: Lindsay Loson
Address: 2261 Market Street STE 10301, San Francisco, CA 94114
Phone# 315-335-8730 Cell # e-mail lindsay@permitflow.com
Architect: N/A
Address:
Phone# Cell# e-mail
Engineer:
Address:
Phone# Cell 4 c-mail
General Contractor: Fairchester Custom Windows LLC
Address: 421 West Ave, Building 1, Stamford, CT 06902
Phonc# (203) 292 - 0367 Cell # c mail PERMITS@RBAWestchester.com
(I)
6/1/2024
5. Occupancy;(1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: Post-construction: N/A
6. Area of lot: Square feet: Acres: N/A
7. Dimensions from proposed building or structure to lot lines: front yard: rear yard: N/A
right side yard: left side yard: other: N/A
8. If building is located on a comer lot,which street does it front on: N/A
9. Area of proposed building in square feet: Basement: IIt fl: 2"dfl: 3rd fl. N/A
10. Total Square Footage of the proposed new construction: N/A
11. For additions,total square footage added:Basement: 1"fl: 2nd fl: 3td fl: N/A
12. Total Square Footage of the proposed renovation to the existing structure: N/A
13. N.Y. State Construction Classification: N.Y.State Use Classification: N/A
14. Construction Type& Location: O Typical Western Lumber Frame;O Timber Frame[TC];O Wood Truss[TT];
O Pre-engineered wood[PW];Located;O Floor Framing[F];O Roof Framing[R];O Floor& Roof Framing[FR];Other:
N/A
15. Number of stories: Overall Height: Median Height: N/A
16. Basement to be full,or partial: finished or unfinished: N/A
17. What material is the exterior finish: N/A
18, Roof style:peaked,hip,mansard,shed,etc: Roofing material: N/A
19. What system of heating: N/A
20. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this
application. N/A
21. 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,..)Yes: No: _ N/A
(if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
22. Will the proposed project disturb 400 sq.ft.or more of land,or create 400 sq.ft.or more of impervious coverage requiring a
Stormwater Management Control Permit as per§217 of Village Code? Yes:—No:—Area: N/A
23. Will the proposed project require a Site Plan Review by the Village Planning Board as per§209 of Village Code?
Yes: No: (if yes,applicant must submit a Site Plan Application, &provide detailed drawings) N/A
24. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: N/A
(rf yes,you must submit a Site Plan Application,&provide a detailed topographical survey)
25. Is the lot located within 100 ft.of a Wetland as per§245 of Village Code? Yes: No: N/A
(if yes, the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan)
N/A
26. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes : No:
(if yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan)
27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: N/A
(if yes,applicant must submit a Tree Removal Permit Application)
28. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: NIA
Indicate:TIER I: TIER Ill: TIER III: (if yes,a Nome Occupation Permit Application is required)
29. What is the total estimated cost of construction: S 41,960 Note.estimated cost shall include
all site improvements, labor,material,scaffolding,fired equipment,professional fees, including any material and labor which may be
donated gratis.If the f nal cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO.
30. Estimated date of completion: N/A
(2)
6/1/2424
BUILD ENT In
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VIL F OF R \ O OK AUG025
938 KNG ET RYE BR NY 10573
�� { VILLAGE OF RYE BROOK
` e �' ov BUI!_OIyG DEPARTMENT
--
4ttttt#*ttt#t#ttt***#*******t##t####t#f###i##*##t###tt####t###'##f####tt######*t###ii####i##t*#*###t#f#R
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE §216 a STORM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST SEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED
ALONG WITH ANY BUILDING OR PLUMING PERMIT APPLICATION. ANY BUILDING OR PLUMBING PERMIT
APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETUfNED TO THE APPLICANT•
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as.,
LISA MARCIANO residing at, 15 Hillcrest Avenue, Rye Brook, NY 10573
I' (Prin[Hamel (Address where yutl 10,e)
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;
15 Hillcrest Avenue Rye Brook,NY.
(tub AddresO
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.
e r r r l--C.
(Signature of Property Owncr(s))
LISA MARCIANO
(Print Name of Property Owilcrts))
�{I h
Sworn to before me this
day of 20 _ CARLOS A WNZALEZ
Notary public-State of Now York
NO.01GO6435350
Quallflod In Westchester County
(Notary Pu My Commission Expires Jun 21,2026
(3)
6/12024
This application must be properly completed in its entirety by a N.Y. State Registered
Architect or N.Y. State licensed Professional Engineer& signed by those professionals where
indicated. It must also 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 andlor not properly signed shall be deemed null and void, and will be
returned to the applicant. Please note that application fees are non-refundable.
♦**********R*i****RRRR*RR****RtittltR**************i***#i****6I******ftNilti************r*k*Mrrrr*******r
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
LINDSAY LOSON ,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)hc is the
Agent for the legal owner and is duly authorized to snake and file this
application.
(indicate architeo,convenor,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,stamp pumps or other prohibited stormwater or
groundwater connections or sources of infiltration into the sanitary sewer system on or from the subject property.
a t^
Sworn to before me this J Sworn to before me this 6ttt
day of L 2Q,,?- day of August .20 25
Signature of Property Owner Signature of Applicant
LISA MARCIANO LINDSA'Y LOSON
Print Name of Proope wner Print Name of Applicant
r �.2htarL Notary c Notary lic Lesly Denise Rascoe
133981440
/ Jt+��rtRt,4tu Lee1y Denies Rascoe
ID NUMBER
COWS A GONZALE2
COMMISSION E7 PIM
Notary Public.State of New York y\e OF .
NO.D I C,06 a 3 5 3 50 antiimr " 8ep1niei�
Qw6fled in Westchester County
My Commission Expires Jun 27,Z026
Electronically signed and notarized online using the Proof platform.