HomeMy WebLinkAboutPP25-177 c yCwo �J DR
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VILLAGE OF RYE BROOK
MAYOR 938 King Street, Rye Brook,N.Y. 10573 ADMINISTRATOR
Jason A. Klein (914)939-0668 Christopher J.Bradbury
www.ryebrookny.>goov
TRUSTEES BUILDING& FIRE INSPECTOR
Susan R. Epstein Steven E. Fews
David M. Heiser
Donald T. Krom,Jr.
Salvatore W. Morlino
CERTIFICATE OF COMPLIANCE
January 28,2026
Max Woltshock&Amanda Chiu
67 Rock Ridge Drive
Rye Brook,New York 10573
Re: 67 Rock Ridge Drive,Rye Brook,New York 10573
Parcel ID#: 135.36-1-2
This document certifies that the work done under Plumbing Permit #25-177 issued on 12/16/2025 for the
decommission and removal of oil fired boiler has been satisfactorily completed.
Sincerely,
Steven E. Fews
Building&Fire Inspector
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BUILDING DEPARTMENT
❑BUILDING INSPECTOR
ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914)939-0668 FAx (914) 939-5801
www.ryebrooLorg
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : / ` 1 -
l� 7 �OC,� �1 � �r2 I �, DATE: � Z Z ZaL(o
PERMIT# ZJ �� 77 ISSUED' Z•/b Z- SECT: /�•rb BLOCK: LOT: Z-
LOCATION: o% 0 OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... ACCEPTED ❑ REJECTED/ REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION '
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS �_",','`�'�/ �►'� �� e LQ I1'I/S S /p
❑ L.P. Gas
❑ FUEL TANK
❑ FIRE SPRINKLER
FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER
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BUIL MENT
VIL EE OK -� I
938 KIN ,NY 10573 DEC 1 2025
ov VILLAGF 'JF RYL: BF"OOK
PLUMBING PERMIT APPLICATION _BUIL.OINr D� ':; 'TII "
FOR OFFICE USE ONLY BP#: PP#: 17 7
Approval Date: DEC i Permit Fee: S
Approval Signature: Disapproved:
i (fees are non-refundable)
DO NOT S I AR7 WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING
INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A
PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF 5750.00
Application dated, S 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 conformance with all applicable Federal,State,County and Local Codes.
1.Address: (y} Q_ Set( SBL: Zone:
2.Proposed Work:-Ocf CUB fi
Eate ;
3.Property Owner: MCh.C Address: Q�-j C OC el�Ct \� , C-�: C�-42S`ACV J-N
Phone#: ��(o- Cell#: email:
4.Master Plumber: Address: Z C C ftliQ� 1 ,YSAk , K I S C O, N1A S�F
Lic.#: 1 Sic _Phone#: 9 14A-2'{ 1`Q4 15Cell#: C1 114- 2Z'4 ?q email:
Company Name: Sa-1(A 24V Address: 1P .M-t
-M'6 C. 1 r�C 1 OS14
INDICATE IXTURES �t
& E ES TO B 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
1 st Floor
2nd Floor
31 Floor
41 Floor
5u Floor
Exterior
5.* List Other Equipment/Provide Details: ts,\n 11 S AW 1 (�� L 'CVV yS
(Notarized Signatures Required Next 2 Pages)
-1- 6/1/2024
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
'F��! SG�Ck?iol1/ ,being duly swom,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.
Sworn to before me this Sworn to before me this \2
day of �_ ,r,20� day ofC 20
Signature of Property Owner Signature of Appll'&int
Print Name of erty Owner Print Name of Applicant
Public N Pub
SULEYMA B.SALAZAR SULEY A B.SALAZAR
�lotary Public-State of New YAr` Notary Public -State of New York
No.01 SA6379344 No-01 SA6379344
Qualified in Westchester: Qualified in Westchester County
My Comm.Expires Aug._'. MY Comm.Expires Aug. 13,2026
This application must be properly completed in its entirety and must include the notarized signarureks, 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-
6W2024
n
BUILD - E MENT
VIL OF RY OOK
938 KING Q „ ET RYE BIR ,NY 10573 DEC 1 2099
4 -0
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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:
x, 1-NGv_- V-- 0 tx Y__ ,residing at,
(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;
lo"? 9_c�V_-_ -i?_, AC'W fir' �6 C t �� r '+�y I C�S'� ,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.
t4��' iuv�-�icr`
(Signature ol'Property Owner(s))
C4
(Print Name of Property Owner(s))
Sworn to before me this l 2—v'c—
day of ,20 c�
(Nota c b )
{ . SUL� E�B.5 LAZAR
i ry Public-State of New York
No.01SA6379344
if:ed in Westchester County
L'.i:t:orcrn.Expires Aug. 13, 2026 -3-
6/1/2024