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BUILDING DEPARTMENT
VILLAGE OF RYE BROOK ?
938 KING STREET RYE BRooic,NY 10573 AU6 -$ 2025
(914)939-0668 VILLAGE OF RYE BRQOK
vww.Ivchrooktly.gov _BUILDING DFPARTMENT
ADMINISTRATIVE EXTERIOR BUILDING PERMIT APPLICATION
FOR EXTERIOR WORK A'HICH DOES NOT REQUIRE VILLAGF ARCHITECTURAL REVlFw BOARD APPROVAI
FOR OFFICE USE ONLY: �j
APPROVAL DATE: 1 1 �u2`L #: c APPLICATION '�3 FEE: 00
APPROVAL SIGNATURE: PERMIT FEES:
H.O.A.APPROVAL: DATE:
DISAPPROVED: OTHER:
.Application dated: 07/25/2025 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the
construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below.
1. Job Address: 71 High Point Circle, Rye Brook, NY 10573
2. Parcel ID#: 124.73-1-18 Zone:_ Pyf
3. Proposed Improvement(Describe in detail):
Installation of ( 1 ) replacement Andersen 200 Series Perma-Shield Gliding patio Door into
existing openings with no structural alterations.
4. Property owner: Gerald Sanders
Address: 71 High Point Circle, Rye Brook, NY 10573
Phone# (914)420-5266 Cell# e-mail geraldsanders@gmail.com
List All Other Properties Owned in Rye Brook:
Applicant: Lindsay Loson
Address: 2261 Market Street STE 10301, San Francisco, CA 94114
Phone tt 315-335-8730 _ c-nsil lindsay@permitflow.com
Architect: N/A
Address:
Phone# Cell= c-mail
Engineer: A
Address:
Phone# Cell ,- e-mail
General Contractor: Fairchester Custom Windows LLC
Address:
421 West Ave, Building 1, Stamford, CT 06902
Phone# (203) 292 -0367 _ Cell # _ c-mail PERM ITS@RBAWestchester.corn
(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 corner lot,which street does it front on: N/A
9. Area of proposed building in square feet: Basement: I'fl: 2°d fl: 3'fl: N/A
10. Total Square Footage of the proposed new construction: N/A
11, For additions,total square footage added:Basement: -I'fl: 2"d fl: 31 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:()Typical Western Lumber Frame;( )Timber Frame[TC];()Wood Truss[TT];
()Pre-engineered wood[PW];Located;{)Floor Framing[F];()Roof Framing[R];()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.
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
(ifyes,applicant must submit a separate Automatic Fire Suppression Sy stem Permit application&2 sets of detailed engineeredpians)
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
(if 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
(f yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan)
26. is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes:-No: N/A
(if yes, the area and elevations of the flood plane must be properly depicted on the survev&site plan)
27. Will the proposed project require a Tree Removal Permit as per§235 of Village Code?Yes: No: NIA
(rf yes,applicant must submit a T)-ee Removal Permit Application)
28. Does the proposed project involve a Home-Occupation as g N/A
p p p ) p per�250-38 of Villa a Code? Yes: No:
Indicate:TIER 1: TIER Ih TIER III: (ifyes,a Home Occupation Permit Application is required)
29. What is the total estimated cost of construction: $ 7,498 Note:estimated cost dart!include
all site improvements,labor,material,scaffolding,fixed equipment,professional(ees, including any material and labor which nraP be
donated gratis. !f the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the CIO.
30. Estimated date of completion: N/A
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6/1/2024
BUILDING DEPARTMENT D nn
—
VILLAGE OF RYE BROOK AUG ' � 2�25
938 KING STREET RYE BROOK.NY 10573
(914)bruok 68 VILLAGE OF RYE BROOK
++++w.rvebrunkm.Qo+ BUILDING DEPARTMENT
AFFIDAVIT OF COMPLIANCE
V]LLAGE CODE 216 • S"roRM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPXRTY OWNER AND BS SUBMITTED
ALONG WITH ANY BUILDING DR PIAMING PERMIT APPLICATION, ANy BUILDING OR PLUMBING PERMIT
APPLICATION SCiBM:TTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL HE RETURNED TO THE APPLICANT
STATE OF NEW YORK, COUNTY OF WESTCHI=STER ) as:
1 GERALD SANDERS residing aL,_ 71 High Point Circle, Rye Brook, NY 10573
being duly sworn,deposes and states that(s)he is the applicant above named,and further states that(s)hc is the
legal owner of the property to which this Affidavit ofCo►npliance pertains at;
71 High Point Circle Rye Brook, NY.
Further that a]I statements contained herein arc true, and that to the best of hisi 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.
�—
GERALD SANDERS
Sworn to before me this �>Fh
day of (fj� , 20 Z`1 BRIM MAC0QNAJ=R
StuOeOfCom#eRc t
�3j
cn 2U:a
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 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 Ynt�1�COUNTY OF WESTCHFSTER ) as:
LIN[ , LOSON ,being duly sworn.deposes and states that ltelshe is the applicant above named,
(print name of individtud signing as the applicam)
and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the
AGENT for the legal owner and is duly authorized to make and file this
application.
(indicate architect,contncMor.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 he 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
Unifon-n 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
properly,and that to the best of his/her knowledge there are no roof drains,sump pumps or other prohibited stornwater or
groundwater connections or sources of infiltration into the sanitary sewer system on or frorn the subject property.
Sworn to before ntc this to? 25th
QJ�,,, SSworntolbefore nu:this
clay of—A-6p .20 204/ d Jul 25
ay of y ,20
signaturz of Pm{+cny t vncr Signatureof Applicant
GERALD SANDERS LINDSAY LOSON
Print Warne of Property Owner Print Name orApplicant
4 �e' U
Notary Public Notar% Public
BRLkN MACDON/#L.D
NOTARY PMUC State of Texas
state of Connecticut
INYC0Jitli)ISWN EXPIRES Oct.312026 County of Montgomery
�rpt #�°Vef' Monique R.Major
IO 1VUNOEn
• C 1]3UZaN5.5
OF S COMMISSION EXPIRES
a,M11mmV`�` ApM 12.209
Electronically signed and notarized online using the Proof platform.
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tv'1 2024