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HomeMy WebLinkAboutEP21-089 M 00 O N _ (14 N N \p N a - , 1-4 W dr to v = W tn H w U tA U W o a ri W O G W w z ` < < a � PLO pa 3 �""� �? a Q 3 w a j �I A co Po" w a,oc H o O , U V W a w 4 Ar V W A z rn A 0cm� a o > s aON00 W U a .. w U zo le " x d 3 tn o0 _ PLOA O u � � �" w H z A cQ ''■' A �" w BUILDING DEPARTMENT VILLAGE OF RYE BROOK APR 15 2021 938 KING,,STREET RYE BROOK,NY 10573 (914)939-0668 FAX(914)939-5801 VILLAGE OF RYE BROOK www.ryebrook.org BUILDING_DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required �/ FOR OFFICE USE ONLY Bp#: BP-20-013 EP#: �0 _ a d C� Approval Date: APR r, mn, Permit Fee: $ -- Approval Signature: i Other: Disapproved: (far are non-refundable) Application dated, 04-14-21 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 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: z' 1 Primrose Lane SBL: 129.25-1-1.80 zone: PUS 2.Property Owner: .5(:z Address: Same Phone#: Cell#: email: 3.Master Electrician: Denis M. Fortino Address: PO Box 713 Rye, NY 10580 Lic.#: E-51 Phone#:914-760-5226 Cell#: 914-760-1046 email: dfortino@enterpriseelec.com Company Name: Enterprise Electrical Consulting Address: PO Box 713 Rye, NY 10580 4.Proposed Electrical Work/Fixture Count: Wiring for Irrigation Meter Pedestal STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Denis M. Fortino being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) Contractor state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the for the legal owner and is duly authorized to make and file this application. (indieate architect,contractor,agent,attorney,etc) The undersigned further states 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 Swo efore is day of 120 day o rL" Signature of Property Owner Signature of Applicant Denis M. Fortino Print Name of Property Owner Print Name of Applicant Notary Public Notary Public 3/21/19 Westchester Rockland Electrical Inspection Services, Inc Phone: 914-347-3595 00 NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue Fax: 914-347-3596 Elmsford, NY 10523 BULL I MIT TEMP k OIST �f �� -013 CITY V1 LA�yF-. 7;0 TOWNSHIP Cgou ,�- STREET / D NOMAD,, LE NUMBER 1 BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANTS NAME BUILDING OCCUPANCY OW RC`S NAAN Aj1BR ,. r�� HOME TELEPHONE NUMBER to CURRENT SUPPL D 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 SIDEWALL SWITCH INCADE FLUORE NO. H.P.EACH NO, WATTS EACH INSPECTION OUTSIDE BASEMENT 1"FL. IN 2-FL. AP 21 3"-FL. --PBUI DING IEEART ENT REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: THIS APPLICATION IS INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE 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 REMS 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, SIZE OF SERVICE FEEDERS W CHARACTER OF WORK NEW❑ ADDITIONAL❑ EXPOSED D CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD p UNDERGROUND 0 AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE:MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF XIGN RE OF PP IC gl L PANY � DATE OF APPLICA N c)x /©A e TELEPHONE NO. / / _J 0 y 5'� C�7 ��'✓✓ FFICE 7JJ��Q(1� �7 LICENSENO.WHEN APPLICABLEif WESTCHESTER ROCKLAND IRE I ELECTRICAL INSPECTIRN 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: Enterprise Electric Inc SC Rye Brook Partners LLC. 254 Sylvan Lake Road NY, Hopewell Junction 12533 Located at: 1 Primrose Lane Rye Brook, NY 10573 Certificate Number: 1028072 Section:129.25 Block: 1 Lot: 1.80 BDC: Permit Number: EP:21-089-BP:20-013 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 inlon the premises at: 1 Primrose Lane 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 04/21/21 Name Type Quantity Service up to 200 Amps Irrigation System 1 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in anyway. Ir-,/�GThis certificate is valid for work performed before date of inspection only.