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HomeMy WebLinkAboutMP25-117 y 04 N con � v y 3 O �..r w Or^. W z O6a ,� •� o a © z O , 4u A W � w SO o J ; y v _ rT cx V wcc g4 �. a vw yC1 w 5 e ° + O w W p Z p 0 v W "so 04 Uzv � a p ~ cn ova � bC� a " Or ti o Q V ■ C? C;" e F00 W v CIN V Z Na o C G+ v v -o V 40 v O V O Vey � C7 �" Q z aW, � � a•v o - A W z Ey 0 � cgb i D L E. Ll FBUILDINOO tRTMENT JUL 2 2 2025 VILI,i ;. ' ROOK 938 KING ST'*i$k ,ic3 ,NV 10573 `$�. VILLAGE OF RYE BROOK �BU!LDINO DE?.AI TMEN, 1` W ngiv ---- APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE . HEATING VENTILATION AND/O AIR CONDITIONING E UIPMENT FOR OFFICE USE ONLY: PERMIT 4: ��+�+! / Approval.Date: J U L 3 5 Permit Fee:$ Approval Signature: Other: Disapproved: (feeq are#**#+*+#+#***** #*++#+#+#++*+*++#+##+######+##########A***able DO NUT START WORK or CONSTRUCTION IATIL A PERMIT HAS BEEN ISSUED By THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COIM1IPLET'ED WITI--I0I�'1'A PERM1IIT IS I2%u OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF 750.00 RE uiREMEN-rS FOR RELEASE OF PFP_MIT&CERTIFICATE OF COMPLIANCE: 1. Properly completed&Signed Application. 2. Site/Staging Plan if Required by the Building Inspector. 3. Copy of Licensed'Contractor's Liability Insurance.(Village of Rye Brook must he listed as certificate holder)& Workers Compensation Insurance on a NYS Board form(Form 0 C 105.2 or Form#L'26.3 i or NY State Workers Compensation Waiver) 4. Payment of Fees/Unit:RESIDENTIAL.=$?00.00/unit•COMMERCIAL$450.00/unit. 5. Complete specifications for each unit being installed. 6. Inspection by the Building Department for removal and/or installation. (48 hour notice required) 7. Electrical work requires a separate Electrical Permit&Electrical Inspection. 8. Numbing/Gas work requires a separate Plumbing Permit&Plumbing Inspection. Application dated, — r�s hereby made to the Building Inspector of the Village of Rye Brook for a permit for the installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County,State&Federal laws, codes,rules and regulations. 1. Address: 10 David Lane SBL: 129.35-1-14.10 Zone: H-1 2. Property Owner: Yavin Muller Address: io David Lane Phone#: (646.)662-9704 Cell C email:yavinmuller@yaho..com 3. Contractor. Yost&Campbell Heating Cabling.and Generator LLC Address: 20 Brookdale PI Mt.Vernon,NY 105M Phone#: 914-668-6461 Gf4 1 Cell#: (permit Coordinator email: Mhanasai@yostandcampbell.com 4. Scope of Work:New Installation{ )•Replacement(x)•Removal( )•Other( ): 5. List F.qui ment: Replacing old HVAC system(please see specs for details) SPA — L —t✓ _ 6. Location of Equipment: inside--and outside 7. Method of Installation/Removal(list all equipment needed to perform job): *please see proposar 1 6/l/2025 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Yost&Camel HeatInSLCoosng,and Generators LLC,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 Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly authorized to make and file this application. 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&Bbilding Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. Sworn to before me this y9\ Sworn to before me this day of V� ,20 �� day of 20�� j Signature of Property Owner Signafure of Applicant r ! Prf t Name of Property Owner Po ne of Applicant Notary Public Notary Public SHARI MEULLO SHARI MEULL0 Notary Public,State of New York Notary Public,State of New York No.01MM60063 No.01ME6160063 Qualified In Westchester County -�-�7 Qualified In Westchester County commission Expires January 29,20� r Commission Expires January 29,2O'V This application must be properly completed in its entirety and must include the notarized signature(s)of the legal owners)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. z 611/2025