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HomeMy WebLinkAboutPP25-176 QR BUIL E MENT Rf t VIL E OF RYE OK F D 938 KIN ET RYE B ,NY 10573 I EC 12 MS L._._�_. Syjq o ny,gov VILLAGE OF RYE BROOK j BUILDING DEPARTMENT PLUMBING PERMIT APPLICATION - �— y FOR OFFICE USE ONLY BP#:_ -- _ PP#: DE A 6 2025 Approval Date: - Permit Fee: S 2_ 2 C . A Approval Signature: 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 WITHOUT A PERMIT IS 12% OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF S750A0 Application dated, 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 detaileNtatement 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: 10 Candy Ln Rye Brook NY 10 SBL: 3-29 Zone: 135.52 2.Proposed work: We are digging on private property for 1-inch waterline, and repair 5 to 10 feet of 1 inch copper tubing to inside the house to the meter. 3.Property Owner: John Grzan Address: 10 Candy Ln Rye Brook NY 10 Phone#: 914-512-4440 Cell#: email: Jgrzan@gmail.com 4.Master Plumber: Josephine OGrady Address: 345 Locust 5t Mt Vernon NY 10550 Lic. 4: 1544 Phone#: 718-325-6000 Cell#: email: Company Namc: Josephine The Plumber Address: 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 ,rd Floor 4"Floor 5"'Floor Exterior 5.* List Other Equipment/Provide Detal Is: �. r l t�'1 Q r QrT,% (Notarized Signatures Required Next 2 Pages) {- 6/1/2024 a 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 in ividual 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. a Sworn to before me this '-` Sworn to before me this da of� day of , t20 C t nature o roperry tignature of App lean Print Name of Property Owner P .nt ,&ac f Applicant Notary Public Notary Public SHARI MEULLO ,uRI MEULLO Notary Public,State of New York P State of New York No.01ME6160063 AE6160063 ' ��1 Qualified In Westchester County .n 4estchester Counry�/ t commission Expires January 29,20 7 Expires January 29,2,n_ This application must be properly completed in its entirety and must include the notarized signatures) 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- 6/1/2024 BUILD NG__ VR�MENT ID � IE C IE u `V E VILtwoi OF RY OOK 938 KING 1c4��ET RYE BIR NY 10573 �.�� .LL� �E� � � 2025 -0 L wv rr 'e uk ov ".;ii.I,AGE OF RYE BROOK , Wr 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 . ST�f'E,OF NEW YORK, COUNTY OF WESTCHESTER ) as/:�,'� r , residing at, #Print nainrl I,1 resswhrre Vou live) being duly sworn, deposes and states that (s)he is the applicant above named, and further states that(s)he itch ` legal owner of the property to which this Affidavit of Compliance pertains at; Rye Brook, NY. (Jroh Addre st 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 f - �z zlz� i;:gr turc of Pr cro, (-)\%r r s I'l][]I Name ut I'rcoperty Opt ner(s)) Sworn to before me this of �^'� , 2(I (Noiarv-Public SHARI MELILLO nary Public.State of New York No.OIME6160063 Qualified In Westchester county-? -3 `-Drrtmissi©n Expires January 29,20Lf 6/1/2024 Side stregt Sylvan Road co 0 r L C J z A � c 4C CZ L U � a� o -� cz ocz 4-00 0 CZ ./) Cf) Q� cz C] r 5xQ o 0) L c L d j f1• Qy C cu .2 C Q CD U O 0U +- lLV C 0 C a C C w 1] O z H-- O .7. CL o U 0 NOMA 21k�l ul Apueo EZOZ Z 1 330-� __ wails ap s BRC�ufi Village of Rye Brook Public Works and Engineering Department 938 KING STREET.RYE BROOK,NY 10573 (914)939-0753 FAx (914)939-0242 INSPECTION REPORT Address: �// /�//` / �i Z' Date: G / �/ � 1 r /f/r/r Name: ,� � Location: `' Permit#: Phone: Email: Work being Inspected: ( / /L 1, ✓ �' / !� Work Inspected is: �ed Rejected Re-Inspection Required Violation Noted Code Section Code Section: Action Taken Code Section: Action Taken 118 Erosion Sediment Pass Fail Violation 210 Storm Water Pass Fail Violation 135 Refuse Pass Fail Violation 215 Street Sidewalk Pass Fail Violation 213 Steep Slopes Pass Fail Violation 235 Trees Pass Fail Violation 216 Illicit Discharge Pass Fail Violation 245 Wetlands Pass Fail Violation Other: ,.la'as Fail Violation Notes: a/ '/ate l /L'- ,/7� Diagram: Signature �' �p Y • t +•yY \ f ' Aft►� �