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HomeMy WebLinkAboutBP25-179 S s ■ Cs w ■ � � N w � N L Ln Goo v ~ ■ N • F d El : R Qv ■ p!Fyj V 1 � U � � � •� to V/ cn CZ v ■ �T1 O C: 0 � y t v �_ to 2 v � 4 A ■ O w o cn � x0 272 w ■ ■ bA H o O $ 4 a o ° �,� ■ o °' w � = b o 4 O N CA _ o a s J x n uo P. Q. CD ci Lin V LO ao x w 0 a ;n Ln : 0 00 ,n w 1 v n W .✓ ., A C7 cCi „� I V V o �,,, a. v o w V ii 1-4 ro ■ � `� Imo!00 E'+ a a ra z O ti up y J• c� r "� cn U W Q " O �' S r as $ © ee ■ N J u V o O o o HF y U O p U j rA V V U z w � > —12�o � o z di aj 84 N y [-I s BUILDING DEPARTMENT F Q IE� VILLAGE OF RYE BROOK ECI 938 KING STREET RYE BROOK,NY 10573 JUL - 3 2025 (914)9�3;�9-0�6� 6$ www,rve *y gov VILLAGE OF RYE BROOK BUILDING DEPARTMENT INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY; Approval Date: JUL 2 4 2y P PT Application Fee:$ Approval Signature: Permit Fees:$ � Disapproved: Other: Application dated: vJ is hereby made to the Building Inspectorof the Villageof Rye Brook,NY,for the issuance ofa Permit forthe interior alteration of an isti building,or for a change in use,as per detailed statement described below. 1. Job Address: o 41 &5 O SBL: Zone:C, 2. Proposed[ provement.(Describe in detail): o r L 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: Yes:X If yes,indicate: TIER I: '� TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic Ere suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No: Yes:-X= (if yes,please submit a separate Automatic Fire Suppression System `` Permit application&2 sets of detailed engineered plans) 5. Occupancy',(I fam.,2 fam.,comm.,etc...)Prior to Construction: 4 After Construction: 6. N.Y State Construction Class' eati n: N.Y. State Use Classification: �A - 7. Property OwnerAt.1 lR I Alt' _C���4Cldress: l Us e ' C K NY Phone# ©1- Q Cell# email: Of() 8. Applicant 7 iOMddress: Ow o7JW%u- Phone# Cell#Z01 -206`0yz0 emae Z& • _�ti �C�'tlml 9. Architect: I Address:92,L M m�OCU �'� + Q[C�� l n:r Phone# Cell# email:tl� v 10. Engineer: Address: Phone# Cell# email: , 11. General Contractor: U t,� r Address:5 S L oLu •_ UQ • _t �e CIO el N d?fou Phone# Cell# !' O - Zo email-Lo l cii C . rr14roJ3,0r1. 12. Estimated cost of construction $ C), (3 d c) Oa (N(?'hE.The estimated cost shall include all labor,material,scaffolding,fixed equipment,professional tees,and material and labor which ma} he dcmutr,l gratis.) l L ? 13. Job Timetable: Start: L Finish: be, ICJ (1) 6/1/2024 BUILD DEPARTMENT [E C R I Q V LS VIL E OF RYE BROOK JUL - 3 2025 938 KING ET RYE BROOK, NY 10573 (9141,U9-0668 VILLAGE OF RYE BROOK wrww nv. 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 NEEWW[YORKK,COUNTY OF WESTCHESTER ) as: }} uG �'1` J ,residing at, f u 1 c—�7 (Print name) (Address where 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; O t� 5+' ,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. ignatur f i6p "41-�(s)) k±i5 AUNT �)"tA �_Q(Awt' (Print Name of Property A )) Sworn to before me this dzLv of (klo 20 � (N , LRiC) ALEMA MARAUN WTAttY PUK C,CAYE OF MEW CORK (2) iwtrsUen MO.61140017KS Oyolled le 1MqtcAMMfC OY 6/1/2024 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 F„NEV YORj{„COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signtng�plicant) and further states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the _��A CAIV= 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. fit,Sworn to be re me this 1i� Sworn to before me this day of vl/ , 24 I S, day of '/&/ , 20 2S ignat of Propenvq. Signature of Applicant DU D ID El` �*As l_. i �.I c— irin slame of Pro 04~ ' Print Name of A ant Nota blic No VALERIYA PAK Notary Public:-State of Mew Jersey ME My Commission Expires Apr 14, 2026 (4) 6n no24