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Home My WebLink AboutPP25-121 = N N N en �I \ N 4-4 Lin 00 F enCAP o F o 00 r o w � H f0l)z S w W x z o o V o � `� O o �;) H coo cn z c rn z o O a F Z wCAo CA cn w (� Z u w o � BUIL jbn . MENT " IE VIL OK JUL 3 0 2025 938 KIN , NY 10573 VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT PLUMBING_ PERMIT APPLICATION FOR OFFICE USE ONLY BP#: PP#: � Approval Date: - w O _ 2 J 2 5- Permit Fee: $ - � Approval Signature: 't � r Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR.THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED NVITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00 Application dated,JU11 304*igtS is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install and/or remove Plumbing as per detailed statement described below.The applicant&property owner,by signing this document agree that said plumbing work will be in conformancewith all applicable Federal,State,County and Local Codes. 1 1.Address: I S+on e- f-c4 u s C o(JI - f 1S-B_L:11��. �7� " f ' � V Zone: 2.ProposedWork: tNde will fe�nnOVe- 0I� Wgl0f t�GI� W� wi �� fep1Gee W;�a neAA) Jj1\Ee.Y, IA)A 4191f h-e C.4 e r '�5 04 1 bl 041 - 90 - Emerge 3.Property Owner: T�rur�QAQ E. . �CA in5 Address: I- 510W-� I I S CO(ur-+- Phone#: 011-'YOD--716 4 0 Cell#: email:hc1 pk re_ op+ml/ re-ne4 4.Master Plumber: Aori O �f Lw I Address: loo 6!fGt ss(an d5 kcc;i' i /r;7s7 )rd P y Lic.#: Phone#: Cell#: email .`u1}gbfl,tC'u rn I nl2• (°G►'r� Company Name: ?AAYl t L (2 IQ 1P151 Address: 160 $60&nJS load ► FIMS-rona NY INDICATE FIXTURES&LINES TO BE INSTALLED AS PER THE FOLLOWING SCHEDULE: Location Water Urinals Drinking Sinks Showers Bath Laundry Domestic Fire Sanitary Natural/ Other* Total Closets Fountains Tubs Tubs Service Service Sewer LP Gas Basement I st Floor 2nd Floor 3,d Floor 41h Floor 51h Floor Exterior 5. * List Other Equipment/Provide Details:�fJa�— &(�(s (� be- C_P P wed I n (Notarized Signatures Required Next 2 Pages) -1 6/l/2024 BUILD � f MENT Q [E QUV I VIL ' OF RY OOK 938 KING ET RYE BR ,NY 10573 JUL 3 0 2025 ov VILLAGE OF RYE BROOK 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 NEW YORK, COUNTY OF WESTCHESTER ) as: 3i, fyN S , residing at, 54one; j I Is co r (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; Ca) rT , 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 d Village Codes. (SigI hi f roperty wner(s)) _RG((4 MCXI 1 S (Print Name of Pr(yerty Owner(s)) Sworn to fore me this zo 17EOUNA BARON-DANZEL day of ?U 2, T.4RY PUBLIC.STATEOF NEW YORK =sL ±N�t Registration No.01 BA0032946 Oualified in Westc6eate�C 'ty My Commission Expires Ul 2a otary Public) -3- 6 1 2024 STATE OF NEW�pYORK,COUNTY OF WESTCHESTER ) as: �y 1 CACi N DCLA0 1 ,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 Master Plumber 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&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations. DEOUNA BARON-DANiEL, NOTARY PUBLIC,STATE OF NEW YORK Registration No.01BA0032946 Qualifiod in Westchester o ety� , My Commission Expire: G Sworn to b ore me this Sworn to bef re me this day of ,20 _ day of ,20,5 �*H V�:3 Si a e of o riy wrier Signature of Applicant kt,,- AW lb Print Name of Prope Owner Print Name of Applicant aA)W-A1( 1 Notary Public MUM BARON.DANIEL ,STATE OF N18 PORK OFOUNA BARON-DANV,fit. allo.OlBA0032946 T,4 KY PUBLIC,STATE of vE1t YORK Westches er u Rcgimatioa No.01BA01� "�.• xpUs ke '•ro completed in its entirety and must of the legal owner(s) of the subject property, and the applicant of record in the spaces provided. Applications not properly completed in its entirety and/or not properly signed shall be deemed null and void and will be returned to the applicant. -2- 6/l/2024