HomeMy WebLinkAboutBP26-011 _
i
a
W c�
` y ti a. C ►�.{ i
' � vi �j C/i � 0.� y •^ p � a
J L
I+rt YCA
W �� :
tz
ui
cn
oo
O w
�; � � � Fri � x z � � i�YW71 Lp"` �. � ❑ -p .� .: ... vA a,.
00 Q =
x W � o V
00 a t z H O � v 0-4
-
C7 c O z O z _ cn
`r/ L 1-0
G, °` u a
�QCN
v W =
'—' i
CA "o V +�
a Fit r.,i r� c� t'-' a: It f
I�
r.
OQn
ONO
z
z 05 .E
u b
a
BUILD, MENT
VILL (E OF RY COOK
938 KING 5 ET RYE BR NY 10573 JAN 0 6 2u26
�z 4 0 -c
wv to
INTERIOR BUILDING PERMIT APPLICATION
FOR OFFICE USE QNLY:
JAN 2 p 2026 `
Approval Date: ermit#: I i r ��r &M!__Application Fee:S i C ( C��f
Approval Signature: Permit Fees: $ C�
Disapproved: Other:
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�ra change in use,as per detailed statement described below,
1. Job Address: st 3� t~7 1ai K f d. RtT_Br&K by SBL: Zone:
2. Proposed Improvement.(Describe in detail): Iu M re-an cle t S
0he i6a` '�roam• wat Canyer-F-Slirwer wto Q, 1iiAt4f-vb, Wk le
01-6 e-f- Wei.! Ceh Vert' 6 Xf�J-NJO 6 f,-f Z_Ft76Lver
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 I: TIER II: TIER III:
4. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic fire
suppression system(Fire Sprinkler,ANSL System, FM-200 System,Type I Hood,etc...) :No: Yes:
(If yes,please submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans)
5, Occupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: --5M 1! After Construction:
6. N.Y State Construction Classification: N.Y. State Use Classification:
7. Property Owner: Alwaal [ Aa tJ I CA)(_ _Address:J 14 h1 ead sa Iw-r K ! . R ge V nyir.1�y
Phone# 571(0-1$3-97-53 cell # g11--7-q9-3a99 email: al�ft� �a!'lt��lr9af�a(. QNt�j7
8. Applicant: Address:
Phone# Cell# email:
9. Architect: Address:
Phone# Cell# email:
10. Engineer: Address:
Phone# Cell# email:
11. General Contractor:71 1 m r e r a ki e t1 r.f t Address:
Phone# 4kIN' U 10. 06 qq Cell# email: kGif<e'tp a�C��ik'Cr�•!dA'l
12, Estimated cost of construction S &P#lWb 'l
(NOTE:The estimated cost shall include all labor,material.scaffolding,fixed equipment,professional tees,and material and labor which may be donated
gratis.)
13. Job Timetable: Start: Finish:
(I)
6/1/2024
BUILD _ TMENT
VILE, r ' E OF RY OOK
938 KING ET RYE BR NY 10573
4 �r
R�M1 Ov
*�'*]`f****i:*****if'ic*}*********iS***'JL9t***i!*ki[i[��.Y`.°r 1F 5Y fY 17P�4 iP 4f'k1F'/Y�C ifkk�;*i if iF hi:i::F***dFi[**s<r.•k**iC F'I:il•*ir**F*iC iC**lF l`f iC****klF lF
AFFIDAVIT OF COMPLIANCE
VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS
THIS AFFIDAVIT MUST SEAR 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:
1, AI UCSa C,�f � �,a � , residing at, J4 1"&Ad&-.j(afK �d• R�e�rbd�'.
{'r: (Address"here WU]a%C)
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;
y fyl et,,)tGt/ g PDadce a►?X) , N , Rye Brook, NY.
L1uh :1�4ilrc„I
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.
6W�S4 au"ri
i 5ign• i °off 1'rupeitr O«ne ►f
iPrint Vftnieut'Propen, Orc (s))
Sworn to before me this
day of , 20 ___
(Aotan Public)
SHARI MRIu.O
NOTARY PUBLIC,STATE OF NEW YORK
4O.01 ME6160063
QUALIFIED IN WESTCHESTER COUNTY
^,t)MMISSION F S AWAR`(29,20ZZ� i 2)
61112p24