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HomeMy WebLinkAboutBP26-018 _ ob � w � e �G N N k3 iv" : N N R_ p E ■ O " Z W u14 PO ■ w � W ° (n v ti C) eq CA LZ �+ 41 /1 1 00 z w o wvy0an � M u7 f-. W r. o �-r w _ CA00 CA N ti dd 0 cn o o c.7 H x o z zo � a � w A A cr uo o a = ■ �+ vs H a � z � � Ij A W o O s z x d o U _,gggg���- D E � BUILD WARTMENT VIL� E OF RYE BROOK .BAN 1 2 938 KING ET Ri� BRQOK,NY 10573 vILL•4GE / QF Fly 0 �ov SuILDING D PARTMEO INTERIOR BUILDING PERMIT APPLICATION FOR OFFICE USE ONLY: Q 1 Approval Date: crm I Application Fee:$ - - Approval Signature: Permit Fees:$ Disapproved: Other: Application dated: is hereby made to the Building Inspectorof the Village of Rye Brook,NY,for the issuance of Permit for the interior alteration of an existing building,or for a change in use,as per detailed statement described below. 1. Job Address:4 91.re Rldeef SBL: !J Zone: 2. Proposed Improvement.(Describe in detail): wmy J7 ab, P-ewmife —I — l��l� I Y h tr ri 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 existing automatic fire suppression system(Fire Sprinkler,ANSL System, FM-200 System,Type I Hood,etc...) :No:4e— Yes: (If yes,please submit a separate Automatic Fire Suppression System Permit application& 2 sets of detailed engineered plans) I5. Occupancy;(I fam.,2 fam.,comm.,etc...)Prior to Construction: After Construction: f 6. MY State Construction Classification: N.Y.State Use Classification: 7. Property Owner: 5h eemm 5ewpuo 1 1 A Address:Ld Pi lit. (Vd.a A-d 0575 ki Phone# !! Cell# �uJ !(?� Z64� email: cJ 8. Applicant: L.2,5 0r!a2ftma4 Address: ZX ¢ plt" 06eT t Phone# Cell#tzm j q-,D33 1 email: 9. Architect: Address: Phone# Cell# email: 10. Engineer: Address: Phone# Cell# email: 11. General Contractor:lrs# It"o G >+t it x/� ores C le b Cori c-683l Phone#,(.03006r7 Cr35 Cell# mail:r rvgfipneN 06) /- ca t, 12. Estimated cost of construction V -�4pt O V cJ INOTE:The estimated cost shall include all labor.material.scaffolding.fiszol equgmscni.professional fees,and material and labor which may be donated gratis.) / /C3 1 13. Job Timetable:Start a! L Finish: OZ f 1 L Z Z.! (I) bn r©24 l B ILD NG 6"TMENT Q U �, VILL �UE OF RYE'*OOK J A N 12 2026 938 KING J� ETRYFB RdotC,NY 10573� VILLAGE OF RYE BROOK ov BUILDING DEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE J21 b - 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, H (LE P Tr"residing at, `� i {Prins namel (address where you li e) being duly sworn,deposes and states that (s)he is the applicant above named, and fiurther states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; c4 0 CA.A , 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. tin (Signature of Property Ow n s)1 51-ICCfgA, 'sCrJ UP -T (Print Name of Property Oti4ner(s)a Sworn to before me this Joni Lamaj 1`r Commission#QILA0025681 day of 20 Z Notary Public,State of New York My Commission Expires-June 07,2028 ( otary c (2) 6/1/2024 This form must be properly completed&notarized by the Design Professional of record and the Property Owner. Failure to provide this completed form with your permit application will delay the permitting process. IDNotice of Utilization of Truss Type, Pre-Engineered N or Timber Frame Construction. (Title 19 Part 1264& 1265 N CRR) VILLAGE OF RYE BROOK To:The Building Inspector of the Village of Rye Brook. BUILDING DEPARTMENT Froth: Subject Property: SBL: Zone: Please take notice that the subject; ❑ One or Two Family; ❑Commercial, ❑ New Structure ❑ Addition to an Existing Structure ❑ Rehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; ❑ Truss Type Construction(TT) ❑ Pre-Engineered Wood Construction(PW) o Timber Construction(TC) in the following location(s); ❑ Floor Framing, including Girders& Beams(F) ❑ Roof Framing(R) ❑ Floor Framing and Roof Framing(FR) Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR§1264 for Commercial Buildings, and NYC RR§1265 for One&Two Family Dwellings. Sworn to before me this Sworn to before me this 577% of ITCOUat^r" 20 26 day 20 26 Sig ure of P perty Owner -. ` / I Signature oT Design Professional l Print N3p&AUppc1TQwncr Prin a of n Professional ( ✓l Notary MohammedRahman Notary Pub tc Commission#O IRA0032973 Notary Public State of New York Mohammad Rahma, My Commission Expiration 01/]7/2029 CODTmL"ion#OIRA0032973 Mohammad Rahman Notary Public State of New York ,1'1C0mmissior4 0IRA0032973 (3) MY Commission Expiration:01/I7r2029 ',,,k 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 YOW COUNTY OF WESTCHESTER ) as: '�515o�rll r4 O. ,being duly sworn,deposes and states that he/she is the applicant above named, (print name of individual signing as the applicant) and fu her states that (s)he is the legal owner of the property to which this application pertains, or that (s)he is the 1 ome i rerc 44C for the legal owner and is duly authorized to make and file this application. (indicate are t,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 Swom to before me this 5ft, day of Jtanuo.r•; , 2016 day of ToMVarld 20 Signature of Pro caner Sign re of Applicank Print Name of Pr Print Name of Applic � r r Notary Public Notary Public Mohammad Rahman Mohammad Rahman Camttiission#OIRA0032973 commission#OIRA0032973 Notary Public State of New York Notary public state of New York My Commission Expiration o1/1712029 My Commission Expiration:01/1712029 (4) 6!1?2024