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HomeMy WebLinkAboutEP22-079 : —■ � N M Cr N N N W N N ` O At OG U M' I U e ■ ci A Cd W O o Z O0.0 LO w w w co O = w N O _ s V O CN 00 f--+ � a ,It W � v � w 00 �- '� H z w C) � F >t Q F-CEWED BUILDING WEPARTMENT MAR 10 2022 VILLAGE OF RYE BROOK 938 KI NO STUET RYE BRQQX,ICY 14573 VILLAGE OF RYE BROOK `�914)939-066�. BUILDING DEPARTMENT w + ydXoqk.org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: _ EP#: -O 72 Approval Date: APR 2 Permit Fee: Approval Signature: V Other: Disapproved: (fees are non-refundable) Application dated, r ac-2 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. f p 1.Address: J�po C� IC �'Jll SBL: 1,3Si cog—1'� =Zone 2.Property Owner: e rvr=� A N It *y JlV A►5 Address:y. ZaC Ili i"c r ��i Phone#: Z7 )1Q6 Cell#: email: 3.Master Electrician: —I Zr►4.Z I Ih—O Address: e Z-AdYko� Lic.#: I L1. Phone#: Cell#: V t� fbo/9 email: e eh—cH�a t� o -3� P y dtfz -'c e"D,?P Address: I &-L)c a! Z11 Ra m! " Corn an Name: rr 4.Proposed Electrical Work/Fixture Count: L lad c h.'+►c '1` �-�'Y� 10S.3 K STATE OF NE�W^YORK,COUNTY OF WESTCHESTER ) as: r11 -,�` -j 1 11 ,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 theI rf rr r,9 p✓ for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.) The undersigned ftuther 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 before me this 1D day of ,20 day of�a rc4 ,20 1� Signature of Property Owner Signature of Appcltcant -�- 6,c,-6 612>& —/iorFit t� Print Name of Property Owner Pri&t Name of Applicant N\(-)a >-- �n La-;- Notary Public N f{ 1LL0 Notary Public, State of New York i :. 01 F.1��516r"053 O---"ied in Westchester County Commission Expires Janus-29.24 anvzo2t STATEWIDE • Service With Itilegrily 0:0 SWIS • : APPLICATION0. Office Use Elect.Permit# _© Da Bldg Permit# Utility ID# Final Certificate# City/Village /�]� zip D Township County Address ff i✓� Cross Street Section Block Lot he Pr I I Owner Name/Address(If different than above) Contact Number Basement ❑ 1st FL ❑2nd FL ®3rd FI. ❑More Than 3 FL ❑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 ew ❑Reconnect }�`j I><- ) 1 ❑Overhead !10hange ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information -r e rill"c- MAR 10 2022 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)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 declares that there is no open applications for the above address with any other inspection company.The applkant,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 �l Address 1�© p ' Cl /S •�, ` Zip Code III I License# Z I1 / Phone If State Wide Inspection Services 1080 Main Street Fishkill, NY 12524 U 3 845 202-7224 Phone 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: ER Electric Corp Geolif LLC 111 Devonshire Road 48 Rock Ridge Drive Larchmont, NY 10538 Rye Brook, NY. 22-079 Located at:48 Rock Ridge Drive, Rye Brook, NY. 10573 Section: Block: Lot: Electrical Permit Number:22-079 135.28 � 73 Certificate Number: 2022-2057 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: 48 Rock Ridge Drive, 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 28th day of April 2022. Name Quantity Rating Circuit Type Temporary Service 01 100Amp Meter 01 Panel 01 Grounding and bonding of service to current codes. officer: Frank 1. Farina This€ertificate may not be altered in any way and is validated only by the presence of a seal at the to€ation indicated.This certificate is valid for work performed can the date of inspection only.