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Home My WebLink AboutEP21-291 ■ ■ ■ s N 1 .--i N ■ ■ • 04 ■ '� � w a G96 Rt M � F ■ r- W x w [-� ■ o W V 00, ■ E-y o E y Q '� � �• o W a d t4ta o w to 0-0 CA W 09 44 o � r" BUILDING DEPARTMENT VILLAGE OF RYE BROOK NOV -8 2021 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 FAX(914)939-5801 VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY RP#: EP#: Approval Date: NOV 021 Permit Fee: $ Z Approval Signature: Other: /:�e.S q/Ve —_2Zkq Disapproved: (foes are non-refundable) Application dated, t I q Zl is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/ r re4nove electrical equipment,wiring,fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. 1,Address: I 'W y M" (-f SBL: I V• T 3—/—10 Zone:ec)—)C 2.Property Owner: Gl ATJ fJ(mil Address:_ W `(0�-A 5 7 Phone#: 114 5 S !D Cell#: 5 MF email: CM5 Z37FP MSA?• Cc" 3,Master Electrician: 1 l+or► A S F U 1,A Address: q S Okjr, 0 All& Lic. #: 1371 Phone#: j1c HqN 4I 2 q Cell#: Sk M(— email:Fl o51cricDIif"L tl ybC 6!1k1L ,com Company Name: 6 N 5 16 iq CO AJ 1r2d t t nl L Z,( L Address: y 0 A V,(-,FN D AVE W*RA45 ynl l0 4.Proposed Electrical Work/Fixture Count: ^ -(PP ±t o ( OW141 EN>i2E 9A5&-" 41 440 n[ vwxld( 0n1 Cl/I C06(L 4mpr66_ I- 00 . 1Wd r4mlLq !&FrtILUI LF W 1 t/G N(,,W 5L AffiJ6C7'$ A WO PA46- .S #####*###xxx######xxxx##################################E#######x#xx##xx#x###xx*xxxxx###*######xx###x#### STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Vt't'h" being duly sworn,deposes and states that he/she is the applicant above named,and does further pnnn ioItic oI Indivi(Iiial+in)IT g a,the a[)I)IW.iIll state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the (Lef_1 R,tC"'_ C0N(AA t Ta fL for the legal owner and is duly authorized to make and file this application. l,un(hcote ar'Aille 1.cunernctol :at„nick cl, ; The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belie£,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 /f> 20 day of . 2Q Si a of Pro Owner �,� Signature of Applicant J/ 1�'"!n�t ,/ A' Print Name o Property er Print Name of Applicant Notary Public Nota P tic G ORGE J. MOTTARELLA Notary Public,State of New York No.4616455 Qualified in Westchester t,axrly Commission Expires Dec.31,2Q ZX 3/21119 Westchester Rockland Electrical Inspection Services, Inc. ``Lry one. 914=347-3595 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue 'W14-347-3 ' 96 Elmsford, NY 10523 BUILDING PERMIT N TEMP k DATE CITY LLAGE ZIP COJE�n TOWNSHIP COUNTY J�`jj STRE D NO.TT ORFpAO ` POLE NUMBER A BE'TWEEN WHAT TTWOO CfOSSSTREETS IS PREMISES LOCATED? SECTION BLOCK LOT NAME BLALDI OCCUPANCY OWNER'S NAM ANO PDRESS HOME TELEPHONE NUMBER CURRENT SUPPLIED BY FROM THEIR OFFICE WORK TELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIDE/WALL SWITCH INCADE FLUORE NO. H.P.EACH NO. WATTS EACH INSPECTION OUTSIDE / Z-- INA _... BASEMENT S is'FL. _ 6 2—FL. 3'FL. VILLAGE OF RYE BROOK REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO HE INSPECTED.IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED,YOU ARE AUTHORIZED TO MAKE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE APPLICANT.THE APPLICANT DECLARES THAT THERE IS NO OPEN APPLICATIONS FOR THE ABOVE WITH ANY OTHER INSPECTION COMPANY.WREIS,INC. IS NOT LISTING,LABELING,UNDERWRITING OR CERTIFYING ANY EQUIPMENT, MATERIALS OR DEVICES WHICH ARE PERFORMED BY OTHER CERTIFIED TESTING AGENCIES OR INSPECTION COMPANIES.THE APPLICANT,OWNER,OR AUTHORIZED AGENT AGREES TO ALL THE ABOVE TERMS AND CONDITIONS AS SET FORTH FOR THE APPLICATION. SIRE OF SEFWICEFE CHARACTM OF WORK NEW- ADDITIONAL 0 EXPOSED❑ CONCEALED O MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERH UNDERGROUND';_; AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY DATE OF APPU TION SIGNATURE OF APPLICAI STREET ^ /J �J :'4TE/�EPHONE NO. J � (— 0 � CRY y''�- ZJPdCOE� LICENSE NO.WHEN APPLICABLE t� AFFIDAVIT IN SUPPORT OF FEE WAIVER RELATED TO HURRICANE IDA STATE OF N&w Yet-9. COUNTY OF Wc-SrcHf5T6-tz NAA5 b( Vl to (insert name), being duly sworn, deposes and says 1. I am the applicant for a Building Permit/Certificate of Occupancy f Demolition Permit lec�anicacn-6 Plumbing Permit I Fence& Wall Permit Mect / Pod Permit(circle all that apply) 2. I am the legal owner of property located at j W f "t�►-+� '�� Rye Brook New York (insert street address)QR I am the (Architec ontractor ngineer/Attorney) (circle one) for the legal owner of property located at I w Y w1.aj 4- . Rye Brook, New York and I am duly authorized by property owner 61RZ41146 ANQR-fir to make and file the accompanying application. 3. The following is a description of(1)the work to be performed under the permit for which Iam applying; and (2)how the work arose as a direct result of Hurricane Ida: A;l 0,km A-6E-9 WN-C / kLy12,4C-W-- i3AS E,1,C- r *N.0 FIBS> f d'o a(t- 4. The work described herein arose as a direct result of Hurricane Ida and does not include Work which was not caused by Hurricane Ida. -7 �� Sworn to before me this _ Day c+f/. vverr ,, 20_� PubI1C GEORGE J. MOTTARELLA Notary Public,State of New York D No.4916455 11�J// Qualified in Westchester County Commissiory Expires Dec.31,20� NOV -8 Z021 JIVILLAGE OF RYE BROOK - BUILDING DEPARTMENT IF Ift WESTCHESTER ROCKLAND ELECTRICAL iL INSPECTION SERVICES,INC. BY THIS CERTIFICATE OF COMPLIANCE THE Westchester Rockland Electrical Inspection Services 43 North Lawn Ave, Elmsford, NY 10523 914-347-3595 (Office) 1 914-347-3596 (Fax) CERTIFIES THAT Upon the application of: Upon premises owned by: Ensign Contracting LLC Christine Sciandra 45 Oakland Avenue NY, Harrison 10528 Located at: 1 Wyman St Rye Brook, NY 10573 Certificate Number: 1032340 Section: 141.43 Block: 1 Lot: 10 BDC: Permit Number: EP:21-291-BP:O A visual inspection of the electrical system at this premise described as a Residential occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 1 Wyman St Rye Brook, NY 10573 Basement 1st Floor 2nd Floor 3rd Floor ❑Garage Attic Outside Other: Inspection was conducted in accordance with the NYS and NFPA 70-2017 International Electrical Code and detail of the installation,as set forth below,was found to be in compliance therewith on 01/17/22 Name Type Quantity Receptacle Convenience ------- 25 Fixture-Luminaire Incandescent ------- 20 Receptacle GFCI ------- 6 Oven Gas or Electric ------- 1 Clothes Dryer ------- 1 Sub Panel ------- 2 Service up to 200 Amps 2 Meters ------- 1 Service Disconnect 100 amp 2 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. This certificate is valid for work performed before date of inspection only.