HomeMy WebLinkAboutEP22-038VILLAGE OF RYE BROOK PERMIT #: EP 22-038
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e BUILDING DEPARTMENT ISSUED: 2/28/2022
938 KING STREET, RYE BROOK, NY 10573 ExPIRES: 2/28/2023 d
10 (914) 939-0668 www.gebrook.oW
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ELECTRICAL INSTALLATION PERMIT ffi
e LEGALIZATION OF 100AMP SERVICE
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AT: 496 FRANKLIN STREET
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BUILDING CLASSIFICATION & PARCEL ID#: R-3 / ONE FAMILY RESIDENTIAL / 141.27-1-43 0
0 PROPERTY OWNER: DERRICK JOHNSON & TINACA JOHNSON (914) 255-5993 I t
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0 LICENSED ELECTRICIAN: ALAN BONISTALL LIC #87 / ALAN BONISTALL ELECTRICAL CONT INC (914) 835-5659 Ift
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In INSPECTION AGENCY: WESTCHESTER ROCKLAND ELECTRICAL INSPECTION SERVICES (914) 347-3595 in
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0 FEE PAID: $150.00 10
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eHOURS OF OPERATION OF CONSTRUCTION EQUIPMENT / VILLAGE CODE §158-4: WEEKDAYS - 8:OOAM TO 6:00PM OR DUSK, WHICHEVER IS EARLIER; 0
SATURDAYS-9:OOAMTo4:00PM; - SUNDAYS&HOLIDAYS-No CoNsrRUCTioNACTmri'ALLOWED ID
i� Michael J. Izzo e
� Building &FiFire Inspector i3
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THIS PERMIT MUST BE CONSPICUOUSLY POSTED AT THE JOB SITE
93
)573
ELECTRICAL PERMIT APPLICATION
FEB 2 8 2022
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP #: / EP #:
Approval Date: FEB 2 8 , Permit Fee: $
Approval Signature: t Other:
Disapproved:
(fees are non-refundable)
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Application dated,cD—c)&-3�-"4- 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.
I. Address: SV/LCC /" SBL: / 1/, a %-1— y 3 Zone:
2. Property Owner:
/ rL Address:
Phone #: _!l?N.P a • ' /ah V Cell #: email:
3. Master Electrician: 4/ A
Lic. #: E� Phone #:
Company Name:
4. Proposed Electri(
Work/Fixturc Count:
_ Address: p e�
email: tSrn0 914.
Address: & Al
STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as:
, being duly sworn, deposes and states that he/she is the applicant above named, and does further
(print name of individual signing as the applicant)
stale that (s)he is the legal owner of the property to which this application pertains, or that (s)hc 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
day of 20
Signature of Property Owner
Print Name of Property Owner
Notary Public
I
Sworn tobefore me this �
day of Ft Lis U-0M
•
Sifi'idfl1rrc of App scant
Print N me of Applicant A /l
Notary Public t/7
FAFIIM NA7 CHOUDHURY
Notary Public - Slate or New York
NO. OICH6260770
Qualified in Westchester County Lg2/=l
My Commission Expires Apr 30, 2024
Elmsford NY 10523�
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DATE
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BUILDING PERMIT NO.
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ZJP CODE
TONTSHIP
COUNTY
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D O.
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POLE NUM
eEW&dkwHATrN0bCAWPREMISES LOCATED? SECTION
BLOCK
LOT
OCCUPANTS NAME
BUILDING OCCUPANCY
NAME AND ADDRESS
J/H1TL
/
H E P NE NUMBER
CURR N SUPPLIED BY UFROM
THEIR OFFICE
WORK TELEPHONE NUMBER
LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED
LOCATION
NUMBER OF OUTLETS
NO. OF FIXTURES A
LAMP RECEPTACLES
MOTORS
HEATERS
OFFICE USE
ONLY
INSPECTION
SIDEWALL
SWTCH I
INCADE
I FLUORE
NO.
H.P. EACH
NO.
WATTS EACH
CUMDE
BASEMENT
BN
Y PL
TMD
T
NEMARKSI LMT OTHER ELECTRICAL DEVICES NOT SET PONTN ABOVL
THIS APPLICATION 15 INTENDED TO COVER THE ABOVE LISTED ITEMS TO BE INSPECTED. IF AT ANY TIME OF INSPECTION ADDITIONAL ITEMS HAVE BEEN INSTALLED, YOU ME
AUTHORIZED TO MANE THE INSPECTION AND ADJUST THE FEE FOR THE ADDITIONAL ITEMS INSPECTED AS PROVIDED BY THE MPUCANT. THE APPLICANT DECI.NES THAT THERE IS
NO OPEN MPUCATIONS FOR THE ABOVE WRH ANY OTHER INSPECTION COMPANY WREIS, INC. IS NOT UETNG. LMSLNK3, UNDERWRRING OR CERTIFYING MY EOUIPMEN,
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 M SET FORTH FOR THE APPLICATION.
SERVICE
FEEDERS
WORK NEW ❑ ADDITIONAL ❑ EXPOSED If CONCEALED C
BUILDING OVERHEAD UNDERGROUND C A 010101 / 1-7 19
I AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED, I
STREET A9DRR6j I TELEPHONE NO.
- ri
Westchester Rockland Electrical Inspection Services, Inc. Phone: 914-347-35
DO NOT WRITE HERE- FOR OFFICE USE ONLY q3 North Lawn Avenue Fax: 9,14-347-3596
i
UCENSE NO. WHEN APPLICABLE
WESTCHESTER
ROCKLAND
ELECTRICAL
INSPECTION
WREISSERVICES. 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:
Alan Bonistall Electrical Contracting Derrick & Tinaca Johnson
53 Purdy Street
NY. Harrison 10528
Located at: 496 Franklin St Rye Brook, NY 10573
Certificate Number: 1033354
Section: 141.27 Block: 1 Lot: 43 BDC: Permit Number: EP:22-038-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:
496 Franklin St Rye Brook, NY 10573
0 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 03/01/22
Name Type Quantity
Service Reinspection-Service 100 amps 1
This Certificate has been approved by Westchester Rockland Electrical Inspection Services.
This certificate may not be altered in anyway. YG
This certificate is valid for work performed before date of inspection only.