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Home My WebLink AboutBP25-240 a O N Ln • FNr � M fn k x a 44 10 _ a�CL w � x z73 O M W c � 0 z O O v cc 72 p O O } A a �I 104 1'*- N p •5 � O ■ •- r�TT A r V w Z Ln v, w w A. �+O OV W 00 P-4 UZ � nac z ` W orn . O c ai U a x a MM M W Ewa a p a vCA c (03 ~ � C z � ,ti v`M 1�I W Q 0 V � x0 O U o o a a v a, w -� 4 v � F+al N z Z A pw a BUILD# _ *�TMENT VILLAGE OF RYE BROOK NOV 2 1 2025 938 KING STREET RYE BRO NY 10573 (914)9 -066�� w ov i INTERIOR 13 U I L D I N G PERMIT APPLICATION FOR OFFICE USE ONLY: , \ Approval Date: DEC 0+8 2025 Permit#: pplication Fee:$ v Approval Signature: Permit Fees:$ of OJCO• Disapproved: Other: .x�*xxxxx*��x,�;xxxxxxxxxxxx,�*,�*x;.,.xxx,.xx*xKxxxxK,�n;,�;x;xxxxx,xxxxx***�*x;,�,.x,xxx,.xxxxxxx,.K�x,x,�xxxx,.xxx,.,.,�* Application dated: is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address: &2 4(N(O ' I— SBL: 130,77 — I — 18 Zone: -�5 2. Proposed Improvement.(Describe in detail): gkjUkTitt1 oP LoWaL L.J V ;L, MA , B UDM bk't'lkk 00=49, AOVRAT10�) OF POWD5k aff A i ADD S00WM2_ - 6tsFk&WM LA&Af NCB , (ZEmoytr cm Wen J o4S'� Law I"9,r e [moopi►i(� QC tmf%; u► A Ly— IrALo 3. Does the proposed improvement involve a Home-Occupation as per§250-38 of the Code of the Village of Rye Brook? No: ✓- Yes: If yes,indicate: TIER 1: TIER II: TIER III: 4. Will the proposed project require the installation of a new,or an extension/modification to an existi�8 automatic fire suppression system(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) :No:_Yes: Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 5. Occupancy;(1 fam.,2 fam.,comm.,etc...)Prior to Construction: 1 FA-MILN After Construction: ( FyqmI IL 6. MY State Construction Classification: N.Y.State Use Classification: 7. Property Owner: kWAV-O }WF-P Address: _ 212 41t* ST k2VG7 emy, Phone# Cell#(914) 5-32- 60506 email: N NO V I' t964c@6pmptL.-.com 8. Applicant:GNA# ASS oW009- Address: Phone# Cell# email: 9. Architect:. 5&CO o15616A t I"C Address: (20 5-R4066 STO RY& K loS 73 Phone# (91d) A o- 345'O Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor: OPTI1uw Bui LD/Ab ddress: 429 DEK 1Z.D- Stl?*RsW Cr- 069o3 Phone# Cell# (M)774--o117 email:CAW6-5061EiW G 1KN11L 12. Estimated cost of construction $ 52,o b 0 (NOTE:The estimated cost shall include all labor,material,scaltolding,fixed equipment,professional fees,and material and labor which may be donated gratis.) 13. Job Timetable: Start: Finish: JAt-1 r (1) 6/I/2024 BUILD1146 DEPA MENT VIL A E OF RYE OOK 938 KnNG ET RYE BRO ,NY 10573 4 -066.�� ov 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: I, R&M, b'PF ,residing at, I M tA69 -s-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; ?��Z V�I 5-r , 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. k (Signatu e of Prop ty Owner(s)) I 6AW "OFF- (Print Name of Property Owner(s)) Q Sworn to before me this / d"t day of )VJ0V N6zr- , 20 �S (Notary Public) ALAN H SOLARZ Notary Public-State of New York No.02SO4992320 Oualified in Westchester County (2) Commission Expires February 24,2026 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 OF NEW YORK,COUNTY OF WESTCHESTER ) as: 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)he is the _ _ _qW N tu12 _ 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. Sworn to before me this ! 4 Sworn to before me this day of N y y e" b Q_r , 20 2-6— day of , 20 Signature of Pfoperty Own r Signature of Applicant Print Name of Property Owner Print Name of Applicant I" A 0 Notary Public Notary Public ALAN H SOIARZ Notary Public-State of New York No.02SO4992320 Qualified in Westchester County Commission Expires February 24,2026 (4) 6/l/2024 U F- W r'¢ �J � C W QI WW a 33-1/2' 1/2' ,�/ H 41' �d1' `� 45'AFF a • n 3 AFF dh BB 24'H PIPES ` U_ _ M U w LL I I a \� w U N UOJ p V N C) N z `4 O J d J U' ci N x £ _m ri w <= x u' EN a W w g w W TO FFICE I W Y �I � �x cn ¢ I = w5 OC o I I LIJ m �w O �I OF- [Z M-I m I LL�a } uj En- I =01-H 1 <Cf) W ol ~w w�bo O ¢� O w0 Z 0 m I 25-i _'m z a uI �m¢ w=I CL OC w 0 Z O uz=7 3 1 J° sislor aooid 9 x z tip U w d z o Z W I (1 ~ 0 cr- F- I W ___ In 8000 ___— LU O z LU.9z 2 000 w F CC Z U U M .eZ ZO p x LL N LL m O .-I I O co I a I � x I sislor aooij 9 x z � q Q m= y�I vI U III U U CL O O `XX a z I M Ln N O CV Z Ln .09 - �` o LJ 1 `V m en cn us LLJ 0 0 0`�- c5.� C `� W J ri UJI >p- �Jg�V J �QW Z CpZ u7wp c � JO OpC Qm W _ �:Ei # < z Z W a Cl W o N CL LL L C C) m N CL to Q, ca in .1