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HomeMy WebLinkAboutEP22-028 00 cq M Q N © a = N N O+y e W © x U s W °w a u .� Pr H Q A n W40. N CR r^I � w5. i M M z WCN z ...� �, 00 CID a („) $ z °z x � o Q o ki V cn W O z Q 00 z H Q ° Q o 1 f1' U ¢ d N A o z W a DDRC� ECENE BUILDING I�EPA IMENT FEB - 9 VIL E OF RYE OK 2�22 938 KNareETRYE B A f ,NY 10573 VILLAGE E OF RYE BROOK 1"39` ` BUILDING DEPARTMENT :or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: d -O a Approval Date: FEB 1 1 Permit Fee: $ �" U Approval Signature: kL�JOther: Disapproved: (fees are non-refundable) Application dated, c�—`�D 3 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. / n 1.Address: QD�� ree�� CAI-e,3 lnz -�1'�ff7iJj�SBL: ZQl r 7+U /—_� 7 Zone:YY� 2.Property Owner: SQ Vr-t '�Zo SS A3Py� am,�n Address: Phone#: Z O-� ` ZT?,- �13 Cell#: email: 3.Master Electrician: Address: Lic.#: Phone#: Cell#: email: Company Name: Address: 4.Proposed Electrical Work/Fixture Count: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: ,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) 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. (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 Sworn to ore me this day of 't G C-t U�lt%n ,20 � d+a�y of r �f' ,20 Si afore of Pro e O er Signature of Ap licant S.r Teo ci W o r a') -t,_f':.Snl �tName of Prop OWner 11 t Name of Applic k-,_ - T—U, Notary PublicSHAPI MELILL© Notary % MEL11­1­O Notary Public, State of New York Notary Public, State of New York No. 01.IJ E6160063 No. 01',4E61 E0063 Otjalified in V'/estchaster County 01_ralified in V�/estch�Eter County Commission Expires January 29.20 Commission Expires January 2.9.20�;13 9/122021 BUILDD4GVMENT FEB - ZOZ2 VIL OF RYE OK 938 KIN ET RYE B ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: —C) Approval Date: Permit Fee: $ V jl�2S Approval Signature: Other: Disapproved: (fees are non-refundable) Application dated, a 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 1bep in conformance with all applicable Federal,State,County and Local Codes. �-7 L 1,Address: {0 Cr �� SBL: a /r ! —/ / Zone: 2.Property Owner: Q �C f Address: 18 re Phone#: O: - -I ell#: email: r �wnwn'F'Xloudtft 3.Master Elecrrtrician: i s hn r Z Address: p Lic.#: �w Phpponye#:"i I �� -�r1,� Cell#: q 141 W- 151 email: t�� w L Q ve uric Company Name: �C,S di �� �Il,�,/C� ,r�� Adpdress: j { e 4.Proon yyp��o��seedy Elec 'cal ork/Fixture Count: l 01, I 1 T V WU 1l 01 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: 3'r ^t n being duly swom,deposes and states that he/she is the applicant above named,and does further (print name of individual signing a4fte applicant) 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. (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 Cade,the Code of the Village of Rye Brook and all other applicable laws,ordinances and regulations Sworn to bef ,me this Sworn to be ore me this 3 r day o ZZ da/y�f '`�'�' ,20 2 - Si ature f Property Owner Si ature of/Applic Print Name:f:Pro arty Owner Print ame of App icatit Notary Public No Public ALEXANDER S.YELLEN CHRISTO /ERJ. BRADBURY NOTARY PUBLIC,STATE OF NEW YORK Notary Public,State of New York Registration No 02YE6279324 No.01 BR61599$5 Qualified in Westchester Cogn>- Commission Expires April 9 20 CCU Qualified in Westchester County 8/12/2021 Cammi scion Expims January 29,20 is STATEWIDE INSPECTION SERVICES,INC. Service With Integfily 0:0 SWIS s 0. Ciff�ce i_l;E Elect.Permit#���� Date Bldg Permit# Utility ID# Final Certificate# City/village Zip Township 'JeVe 5Ndy/ County Address I�� eV ` Cross Street Section Block "•Lot Owner Name/Address(If different than above) Or' ez r Contact Number ll —} Basement ❑ 1st FI. ❑2nd FI. ❑3rd FI. ❑More Than 3 FL ❑Garage ❑Attic IyOutside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact -1 Amt Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information ]DECIENE FEB — 9 2022 -ID) VILLAGE OF RYE BROOK BUILD-NG_DEPARTMENT This application Is valid for one(1)year from the date received by 5Wt5.This appilmlon is intended to cover the above listed Items to be inspected,N at any time of Inspection additional Items haw been WWS04 you are authorized to make the inspection and adjust the fee for the additional hems tnspected.The applicant declares that there is no open applications for the above address with any other Inspection company.Theapplkant owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name Date Signature f Address c 1(, City/State d Zip Code License# Jll�(0 1 Phone If l _ �Q 4-7 S R C C� IE � V LF I State Wide Inspection Services CAC) 1080 Main Street Fishkill, NY 12524 �� MAY ' 2 2023 845 202-7224 Phone 914-219-1062 Fax STATE WIDE IN57EC710N SERVICF� VILLAGE OF RYE BROOK Email: office@swisny.com BUILDING DEPARTMENT Website: www.swisny.com Service With Integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Lelia Electric Corp Sarah Ross Benjamin Richard Zweig 218 Tree Top Crescent 47 Greenway Lane Rye Brook, NY 10573 Rye Brook, NY 10573 Located at: 218 Tree Top Crescent, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 22-028 129.76 � 64 Certificate Number: 2023-3017 Building Permit Number: A visual inspection of the electrical system was conducted at the Residential occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 218 Tree Top Crescent, Rye Brook, NY 10573 The Exterior was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the installation, as set forth below,was found to be in compliance on the 27th day of April 2023. Name Quantity Rating Circuit Type EV Charger Receptacle 01 50AMP i 1 / ^�+ Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a seal at the location indicated.This certificate is valid for work performed on the date of inspection only.