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HomeMy WebLinkAboutEP21-325 e a L a N a ch N M M `� ■ �v Men > o. 0 N � en ON oq fn O O 0 7 rU °Q r ■ s � N ICI © U A ICI gz U V kn U V a, ■ U a V U C � A z u WetV W z M z w O ad w ^^� ■• A 0. Z �l a �I a *wl 4 w � � yE t3RC'>U BUILIis MENT DEC - 8 2021 VIDE OF RYE OK 938 KIN ' ET RYE 11 ICY 10573 VILLAGE OF RYE BROOK (914)9 939-5801 BUILDING DEPARTMENT w 1t or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY RP#: EP#: C Approval Date: DEC ] 3 2 Permit Fee: $ 1 Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, fcA-sg"`co-), 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: K r ee�� SBL: 14111 c)/-7 —/-1 ZoneC/�� 2.Property Owner: Address: ,,-.Phone.,, Phone#: —T Cell#:.�1 email: 3.Master Electrician: '4�V%C�& 7lcc c u iv a s Address: 8 1 r" � bE A u e -h y� Lic.#: 7,�'f Phone#: Cell#.. /!(- Fd�-it 60 email: 4 eyv Z O-C(- Nj Company Name: c 9�y t �l4'� Address: 57( m v� 4.Proposed Electrical Work/Fixture Count: cc STATE OF NSW YOM COUNTY OF WESTCHESTER ) as: L 4 69 duly sworn,deposes and states that he/she is the applicant above named,and does further rin nam of rn ivirtual signinbas t appkicant) -7�I � state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the 1/ for the legal owner and is duly authorized to snake and file this application. fi is a architec,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 �ee this / Sworn to bef a me this day; ,2 ;� 1 day o ,20 i A. ignatur of aperty weer S1 ure of pp J� �c t � Print a of Property Owner Print 1 ame of Applicant 6AC,NON Nb141k1!]r PUBLI �0 OF NEW YORK NOT Y - OF NEW YORK No. 0 10 38 N G 238 Qualified es ester County Quail red in stc ester County My Commission res October 14. 20--/_- My Commission Expires October 14, 20_ � 1 3/21/19 Westchester Rockland Electrical Inspection Services, Inc. Pnode.4 i/-3 P95 DO NOT WRITE HERE-FOR OFFICE USE ONLY 43 North Lawn Avenue FpE 4-341-3596 Elmsford NY 10523 f BUILDGPERMTOI TEMP# �� Q CITY OR VILLA _ ZIP GODS TOWNSHIP / CJ COU STREET AND NO.OFf ROAD Y�_ POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCAT 7 SECTION BLOCK LOT OCCUPANT'S NAM' ,., J !DING OCCUPANCY OWNER'S NAME AND ADDRESS i 'HOM 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 SIDEWALL SWITCH INCADE FLUORE NO. H.P EACH NO. WATTS EACH INSPECTION OUTSIDE - BASEMENT 777 11'FL. 2`"FL. 3'FL. V I L ILA E F )yr: PQrnV BUILE ING DE DARTME NT REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE: I A 2 L- THIS APPLICATION IS INTENDED TO COVER TH ABOVE LISTED ITEMS TO BE INSPECTED. IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED, YOU ABE 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 ADDFTIONAL EJ EXPOSED n CONCEALED D MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD L UNDERGROUND Ll L-[- i I I I AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. t NAME OF C MPANY DATE OF PU ION SIGN C X STREET ADDRESS TELEPHONE NO. L CrrY OR POST OFFICE LICENSE NO.WHEN APPLICABLE 7 n WESTCHESTER ROCKLAND ELECTRICAL INSPECTION WREIS,ER,,C,,,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: Zaccagnino Electric Win Ridge Realty LLC 81 Maple Avenue NY, Rye 10580 Located at: 134 S Ridge St Rye Brook, NY 10573 Certificate Number: 1032366 Section:141.27 Block: 1 Lot:6 BDC: Permit Number:EP:21-325-BP:O A visual inspection of the electrical system at this premise described as a Commercial occupancy,wherein the premises electrical system consisting of electrical devices and wiring,described below,located in/on the premises at: 134 S 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 12/20/21 Name Type Quantity Camera Indoor,Outdoor ------- 10 This Certificate has been approved by Westchester Rockland Electrical Inspection Services. This certificate may not be altered in anyway. This certificate is valid for work performed before date of inspection only. f