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HomeMy WebLinkAboutEP21-304 S' S S N N W ri yC � � � N � � • �i W G cQ Q A 00 © W a = • H I _ o72 ry ,00� o z Q < a p Q" U � � w 3 ssss� co E- 9z OC x � v o , Q d W ° o s• D CCC �M BUILDING DEPARTMENT NOV 19 2021 DID VIL�sA,,,GE OF RYE BROOK 938 I{nvdET RYE BI, ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT :or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: C�)/_3 0 Approval Date: NOV / �i Permit Fee: $ L Approval Signature: IVOther: Disapproved: (fees are non-refundable) Application dated, t 9 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: d 9_� ki©RT\.4 Q � d.Cle_ S_T SBL:/351 35—f—/j/ Zone:'e IO 2.Property Owner: LZ e OL 1 1LI y 5 Address: s2q 3 No n7 44 R k4 ejo sr . R"] t f7w Phone#: Cell0� email: 3.Master Electrician y Se-P M r c.o U Address: / IL A o j r,,a-T I it Q W th,J 2,.t s Lic.#: && Phone `Ny(6- 15 OP Cell#: i-1-`lit, r< email: d se® (dC_"N!a,C.Van Company Name)hO' )Zdc c�,, � ro ,ti z:rLC. Address: // '3'Lrq,014L ,?5 (?-+4' 4.Proposed Electrical Work/Fixture Count: tLf_ 1 ��}c7D leap fleC-I?c- 5e 7 ,a STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly swum,deposes and states that he/she is the applicant above named,and does further (print name of individual signing as the applicant) state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is thef�y GT 7 1[A(, CL/u 214 c i o?, for the legal owner and is duly authorized to make and file this application. (indicate 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 \C)I Sworn to before me this g day of QVo :f ,20 � day of�\3i)v p,zl ,20 _ n1m)"'g rm �' Si a e of Wbpe,rty/jOrner SiVnature of Applicant ayit erne 77M Prmt Name lic t XA Pub SHARI MELILLO M EIERLEIN Notary Public, State of New York NOTARY PUBLIC,STATE OF NEW YORK No. 01 ME61600,63 Registration No. 01 DE620941 I Qualified in Westchester County Qualified in Putnam County Commission Exnires January 29,20 8/12/2021 Commission Expires JULY 27, 20aJ Westchester Rockland Electrical Inspection Services, Inc r P one: 9 4-347-3595 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue "' Fax: Q14-347-3595 MI C Elmsford, NY 10523 � BUILDING PERMIT NO. TEMP# DATE CDY OR VILLAGE SIP CCI�E �j TOWNSHIP [[ ry V ( 10 - WYD STR�.7 .OR ROAD 1 i POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMI S LOCATED? SECTION BLOCK LOT CUPANT'S NA BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS LgP NE 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 SIDEWALL SWITCH INCADE FLUORE N INSPECTION OUTSIDE I� BASEMENT 1�FL NOV 19 2021 2f FL. 3' FL. I JBILDING DEPA TMENT REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: 1 NS Q Q- 000 4!1"+,D W h-e 0 q 1 19-,7 e, s crr.n Uj C I n:;, h v�/U-11 OA---A 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 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. SIZE OF SERVICE FEEDERS CHARACTER OF WORK NEW L7 ADDITIONAL❑ EXPOSED P CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD f UNDERGROUND❑ AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACESPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. 0-Se-0 k 1� l (Z)Vl t-I Ly t ` ?J-� SIG TUBE OF APPLICANT NAME OF COMPANY DATE OF APPLICATION Thzl20 G CI)rp,OGrj J Df n STREET ADDRESS TELEPHONE NO. car R POST OFFICE ZIP CODE LICENSE NO.WHEN APPLICABLE i r a L� IF WESTCHESTER ROCKLANO Q- ELECTRICAL 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: The RDC Company of NY Inc Peter&Lee Elkins 11 Bradhurst Avenue NY, Hawthorne 10532 Located at: 247 N Ridge St Rye Brook, NY 10573 Certificate Number: 1031966 Section: 135.35 Block: 1 Lot: 14 BDC: Permit Number: EP:21-304-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: 247 N Ridge 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 11/23/21 Name Type Quantity Service Reinspection-Service ------- 1 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in any way. � G This certificate is valid for work performed before date of inspection only. JY