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BUILDING DEPARTMENT AUG 18 2022
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573 VILLAGE OF RYE BROOK
(914)939-0668 BUILDING DEPARTMENT
wwwryebrook.orm -�
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP#: EP M t � 9 2
Approval Date: AU
1 9 1 Permit Fee: $ J—J06
Approval Signature: Other:
Application dated, 08-10-22 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. By signing this document, the applicant & property owner agree that all electrical work
performed will be in conformance with all applicable Federal,State,County and Local Codes.
1.Address:—V— Primrose Lane (A3wacen+�) SBL:_ 129. -1-1 .q1 _zone: 'PUD
2•Property Owner: SC Rye Brook Partners Address:_5 International Drive
Phone#: 914-481-1531 Cell#: email:
3.Master Electrician: Denis M. Fortino Address:__PO Box 713 Rye, NY 10580
Lic.#: E-51 Phone#: Cell#: 914-760-5226 email: df0 Imo n
Enterprise lec com
company Name: p 'se Electrical Consulting Address: PO Box 713 Rye, NY 10580
4.Proposed Electrical Work/Fixture Count:
Wiring for Irrigation Meter Pedestal 100 amp
5.31 Party Electrical Inspection Agency: S W I S
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STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
I S M. 1~ov-h Y1 b 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) 1 �^ L state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the_EJeG/Y! CG ( DYl l 1 Q��D�
for the legal owner and is duly authorized to make and file this application. (indicate architecs,contractor,
The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work attorney,etc.)
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 tobefore me this Sworn to fore me _
s a
day of ,20 day o 20
Signature of Property Owner S ature of Applicant
Prat Name of Prope Denis M. Fortino rty Owner ame of A lican
Notary Public b
Notary Publm'�
Notary Public State of New York
No.01ME6160063
Qualified In Westchester Count)6/23/2022
Commisslon Expires January 29,26za
STATE WIDE INSPECTION SERVICES, INC.
Service With Integrity
0:0 • •
SWIS • 0. •
Office Use Elect. Permit# ?1 _ 9�3 Dat
E 2-
Bldg Permit# — Sq Ft
Plumbing Permit#
Final Certificate#
City/Village � f- n C�� Zip �5'73r Building Dept g/�., ,e County
Address Ifs` ,/'� y yI_ Cross Street / SeclieaOc�T�` Block / Lot
Owner Name/Address(If different than above)<
D 9�O C Contact Number
❑Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic Nn Outside ❑Residential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact
Amt Amos
Range(s) Cooktop(s) Oven (s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch
SERVICE
Amperage #Panels # Meters # Disconnect ®Underground ® New ❑ Reconnect ❑ Repair
T/T/Vo / ❑Overhead ❑ Upgrade ❑ Disconnect
Utility ID# 11�1�- % 7 <�-2 Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland
vl PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
L�1 Rl k rum l 121,2CA-� ��TL� � � i��J 14k'-rP
D 1VV'
AUG 18 2022
ID
VILLAGE OF RYE BROOK
BUILDING DERARTfv1ENT
1 his 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 anytime of inspection additional items have been installed,you are
awhnrized 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 applicant,
owner or authorized agent agrees to all the above terms and conditions as set forth for the application.
Email Address / �/ l ESL.- �Zp Name U 7 , �
License # —� Date — �� Signature
Address—_ � Ljx�7 13 City/State Zip Code 5�i.ompan-r
cjk�
R D FEE, �V E- DState Wide Inspection Services
1080 Main Street
NOV � 8 2022 Fishkill, NY 12524
845 202-7224 Phone
VILLAGE OF RYE BROOK 914-219-1062 Fax
STATE WIDE INSPECTION SERVICES BUILDING DEPARTkIENT Email: office@swisny.com
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:
Enterprise Electric Corp. SC Rye Brook Partners LLC
PO Box 713 5 International Drive
Rye, NY 10580 Rye Brook, NY 10573
Located at: 12A Primrose Lane, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: 22-193
129.25 1.91
Certificate Number: 2022-7757 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: 12A Primrose Lane, 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 17th day of November 2022.
Name Quantity Rating Circuit Type
Service 01 100AMP
Meter 01
Panel 01
Grounding and bonding of service to current codes.
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.