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HomeMy WebLinkAboutEP22-131 s = a _ t-4 It 4-4 o = M °Q ar eq w �. A � T e N h V P-1 p °Q4*4 ZI^1 a O © M ^ i' 00 z Z w � �W Ln C w rram� .. A H � to tz cn (� H � O w 4 p zz � o h +�-+ w 4 3 a N U o w z GO c z A 1-1 A H BUILDING I�EP NT VILLAGE OF RYET K J U L - 1 2022 938 ICUIdIZEET RYE B NY 1fl573 VILLAGE OF RYE BROOK (914)939-16 „! BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: cDQ-1,3 Approval Date: Permit Fee: $ Approval Signature: Other: Application dated, —c7­� is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of a Permit to install an or remove electrical equipment,wiring, fixtures, or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal,Sta ,County and Local Codes. 1.Address: �t>��� ►"'� ' SBL: / 7/r,3 5�t�aa Zane: 2.Property Owner: OL )A-Ak-Address: 41 Hti„.n4 AAA_ Phone#: Cell#: q(`�` '"+t�"`i144 email: .1.tr.�.�}In�7a7 r4Gl 3.Master Electrician: C w 1 �`l�t,� Address: Lyr,y 4u AAC A1L' Lic.#:1t7 Phone# P-�-(r(p7-57 f Cell#:G1Y'-" 4&---5Z?`( email:cls'­2 i&C_W1 �rkyw�LlrL `V-PL•341 Company Name: [, Lr1Y!_� 'L Address: L-[(..Y 5W /Sr- .M4 Q- /GSA 4.Proposed Electrical Work/Fixture Count: VJ r 4 CGL "7 �,,�r 2 C> 5.31 Party Electrical Inspection Agency: t,- y S wwwwwwwwwwwww,tw**wwwwwwwwwwwwwwwwwwwwwww*wwwwwwwwwwwwwwwwwwww*ww**wwwtrwwwwwwwwww,rw*w*ww*wwwwwwwwwwwwwwwww 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) 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 befor me this day of ,20 dwof 52 20 fp� Signature of Property Owner Si atur of pplicant Print Name of Property Owner Print Name 6f Applicant Notary Public Notary Public 6/23/2022 STATEWIDE • Service With Integrity 0.0 SWIS • 0. Office Use Elect.Permit# I /13 Date Bldg Permit# � Utility ID# Final Certificate# City!Village o Zip S Township Counvie Address 95-'> DN'0v Cross Street Sectio y Block35 Lot_ -s i Owner Name 1 Address(if different than above)` Contact Number r -1_ �,,�+CS -.2�i1+� ❑Basement 1st FI. ❑2nd FI. ❑3rd Fl. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps 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 V-k— pAit-we JUL - 1 2022 L VILLAGE OI= RYE BROOK BUILDING_DEPAMTMENT This application is valid for one(t)year from the date received by SWIS.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.The applicant dedares that there is no open applications For the above address with any other inspection company.The applicant,owner ar authorized agent agrees to all the above terms and conditions as set Forth for the application. Inspector Date Finalized Inspector# Company Name �y 1>`\r✓ Date I t 7 2 Signature Address <j _ �t�..4.t_ 1k _ City/5tatAA, - Zip Code o5W50 License# Vt7 vT y` /� Phone# �- CD 4 State Wide Inspection Services 1080 Main Street CAC) Fishkill, NY 12524 845 202-7224 Phone 44 INK U 5 914-219-1062 Fax STATE WII?E INS RE CT I ON SERVICES Email: officeC&swisny.com Website: www.swisny.com Service With integrity BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTI FI ES THAT: Upon the application of: Upon Premises Owned by: C Williams Electrical Construction Inc Washington Park Plaza Chris Williams 253 South Ridge Road 464 South 10th Avenue Rye Brook, NY 10573 Mount Vernon, NY 10550 Located at: 253 South Ridge Road, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP22-131 141 35 2.51 Certificate Number: 2022-3801 Building Permit Number: A visual inspection of the electrical system was conducted at the Commercial occupancy described below.The electrical system consisting of electrical devices and wiring is located in/on the premises at: 253 South Ridge Road, Rye Brook, NY 10573 The Firs Floor CVS 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 13th day of July 2022. Name Quantity Rating Circuit Type Replace Main Fire Alarm Panel 01 Officer: Frank 1, 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€ertif cate is valid far work performed on the date of 1nspe€tion only. . O 4t oo rq i N c N , N 00 ►. w w `n a vi O� in W v a a M a ..� w a z w c Cn o y f " N ►C, g G CC = z CD � OD w z A M o `n I" I 00 21 WU a a, H , w z w f, w z H w a _ V o w z 64 M v H A o LZ 04 ON w x �n _ : D rc� LE � V# 1E D JUN - 8 2022 ' `�: . . VILLAGE OF RYE BROOK $umpz/NG DEPAIt'J i IENT BUILDING DEPARTMENT WrLI'V. ;QF R`f�'E$ROOK 938 KIN0\STRFST RYE BROOK,NY 10573 `:(914)'939=6668.` �` -_ 7 ty W.tV;r,]�bI001C ELECTRICAL PERNIIT APPLICATION Westchest C p\nty Master Electricians License Required FOP,OFFICE USE ONLY gP . LP#: — 0 Approval Date: J UN 8 2022 Permit Fee: S ate 5 ' �/� Approval Signature: i' Other: Disapproved: (feu are not-refundable) #t##R##f ##tst##t#tlttkit##t##tt#tt#t#tt###tAt##titRf##TtiR+1###♦1.t###rt.RRR##i Ritkhi►#t Application dated,� e �is hereby made to the Building Inspector of the Village of Rye Brook i\'Y,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 & propert), owner, by signing this document ao ce that all electrical work perfortued will beTinn conformance with all applicable Federal,State,County and Local Codes. 2 C 1.Address: / 3 S6,.*k K t do e- S+reer SBL:�JE—Qt�/ Z.onc:(d-J 2.ProperlyOwner: Washington Park 'Plaza AS!X99�s�tes L C 41 HPwi tt AVPnue, Rrnnxville Phone P: Cell M:Q 1 dql Al 166 email1M�>rt#� ^4��,�3e1�6emNY 10708 3.Master Electrician: may' t��1u�,�-ti Address: Lk,44 4A-, IQ,+S A.,,- ill L,�--f-v j-V-/ Lic.aY: �"f i, Phone Company Nante:�_1/U�1 �tn�� Rct Address: { /A1 ~� MI �"�'�" /GSiV 4.Proposed Electrical Work/Fixture Count: � ' Fire- 4 Lac-e. 21t��1 t,Jf•z d rreO e g--*Agc�vre/` rePrgcmm4 F %el �v -rZt.d 4o Spg_ct" S 4e **R}t}RR}*R}tR}t***tR*f}tit Rt*RRRRtR*R}aR FRRRRRRR R*RRRRR*RRf Rf RR*R**tRtR}R�}f}►*i is RfRRRi RRRRi}iRt}tfif#R STATE OF NEW YOM COUNTY OF WESTCHESTER ) as. Martha Levy ,being duly sworn,deposes and states that he/she is the applicant above named,and does further (ptvt name of individual signing as the a.pp'.ican() sate that(s)he is the legal owner of the property to which this application pertains,or that(s)hc is O,c Manag i nq_Agent for the legal owner and is duly authorized to make and file this application. (indicate archit:ct,contractor,aged,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 sct forth and contained in this application and in Any accompanying Approved plans and specifications,w well as to accordance with the New York State Unifotru Fire Prevenuun&Building Code,the Code of the Village of Rye Brook and All other applicable laws,ordbrances and reguladons. i Swom to e o m this Sworn to before me this day of d ay f 20 Signal rf rc of Property cr2r Si atutc CAp cant Print Name of Propc cr Print a of pp nt ri, Ito p ie M SUOZZO Notary lie NOTARY PUBLIC,STATE OF NEW YORK CHRISTOPHER J.BFUURY Registration No.01 SU6070919 Notary Public,State of New York Qualified In Westchester County No.01 BR6159985 My Commission Expires March 11,2092 Ou?lifted in Westchester County jf24V t Commission Expires January 29,20 Westchester Rockland Electrical Inspection Services, Inc. 6 Phone: 914-347-3595 DO NOT WRITE HERE—FOR OFFICE USE ONLY P.O. BOX 208 Fax: 914-347-3596 Carmel NY 10512 �� � � ��� BUILDING PERMIT NO. TEMP N DATE CITY OR VILLAGE ZIP CODE TOWNSHIP OUNTY �L �✓'.� �. �� �c1L �% � '�/ STR D NO.OR �J POLE NUMBER BETWEEN WHAT TWO CROSS STREETS IS PREMISES LOCATED? SECTION BLOCK LOT OCCUPANT'S NAME BUILDING OCCUPANCY OWNER'S NAME AND ADDRESS fv } i -z4— L- HOME TELEPHONE NUMBER �� CURRENT SUPPLIED BY FROM THEIR OFFICE VVELEPHONE NUMBER LIST BELOW ALL EQUIPMENT WHICH YOU INSTALLED NUMBER OF OUTLETS NO.OF FIXTURES& MOTORS HEATERS OFFICE USE LOCATION LAMP RECEPTACLES ONLY SIOEWALL SWITCH INCADE FLUORE NO. I H.P.EACH NO. WATTS EACH INSPECTION OUTSIDE --- _- BASEMENT If FL. Y°FL. 3-FL. UILDI G DEP R_TMFId REMARKS:LIST OTHER ELECTRICAL DEVICES NOT SET FORTH ABOVE:' THIS APPUCATION 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❑ ADDITIONAL O EXPOSED❑ CONCEALED❑ MUST ENTER APPLICANTS IDENTIFICATION NUMBER SERVICE ENTERS BUILDING OVERHEAD❑ UNDERGROUND❑ AVOID DELAYS BY GIVING FULL AND ACCURATE INFORMATION.ALL SPACE MUST BE FILLED IN OR APPLICATION MAY BE RETURNED. NAME OF COMPANY. DATE OF APPLICATION SIGNATURE OF APPLICANT STREET ADDRESS TELEPHONE NO. CT�OFFICE/ ,..f / `%! ZIP CODE LICENSE NO.WHEN APPLICABLE