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BUILDING DEPARTMENT AUG � 8 2022
VILLAGE OF RYE BROOK VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573 BUILDING DEPARTMENT
(914)939-0668
www.aebrook.org
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required nn �]
FOR OFFICE USE ONLY BP#: EP#: fX- / "�
Approval Date: AUG 1 9 202212 Permit Fee:
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.
I.Address:_21 Jasmine Lane (Adiacen+) SBL: 129.25-1-1 .46 _zone:-4--b b
2.Property Owner: , , Rv Rrnnk Partners Address:9 Internatimal Drive
Phone#: 914-481-1 L l Cell#: email:
3.Master Electrician: Denis M. Fortino Address: PO BOX 713 Rye, NY 10580
Lie.#: E-51 Phone#: Cell#: 914-760-5226 email: dfatinO nt rpriseelee corn
Company Name: Enterprise 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
STATE' OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Uerl )S YI. FUV-h r) 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) II-- �I "state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the�l4eCTY cc-1 Grr yC r_+oY—
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 Swo or e ' V
day of 2p
day �� 20
Signature of Property Owner Signature of Ap
Print M. Fortino
Name of Property Owner Name of Applic
u i�sUL�
Notary Public Notary Public
SHARI MELILLO
Notary Public,State of New York
No.O1ME6160063
Qualified In Westchester County
commission Expires January 29,209L*22
STATE WIDE INSPECTION SERVICES, INC.'
0•0 • •
JOB APPLICATION0. •
swis
Office Use Elect. Permit# _ Date
Bldg Permit#
Sq Ft
Plumbing Permit#
Final Certificate#
City/Village K Zip Building Dept. /� `/J�,. ` County
Address /1_ / � Cross Street' / L/? Sectio(,`V,, Block % Lot
Owner Nam�e�/f Address(If different than abovej,: A , okcal_l n ��„��� Contact Number
❑Basement ❑ 1st FI. ❑2nd FI. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic �utside ❑Residential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact
Amt Amps
Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch
SERVICE
Amperage #Panels 1P/ 3P # Meters # Disconnect Underground New ❑ Reconnect ❑ Repair
Nf � - -
!C1� Overhead ❑ Upgrade ❑ Disconnect
Utility ID# / i� 7 Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland
J PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
u
I,
AUG 18 2022 l
V s
(
VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
This application is valid for one(1)year from the date received by SWIs.This application is mtenaed to cover the above listed items to be inspected,if at any time of inspection additional items have been installed,yoc a,,
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 applicant,
owner or authorizeJ agent agrees to all the above terms and conditions as set forth for the application.
Email Address Drop I i 'Lo�/L-)j2�106-,7-- �cc ,&w Name
License it Date Signature
Address 7 � _ __-- City/State Q Zip CodeGJ�
Company f- �i �t G"�/ i��li C_C7�5 / Phone# / -7(-1—C) ���
State Wide Inspection Services
CAI) NOV 21 2023 1080 Main Street
Fishkill, NY 12524
TOW U t 845 2 Phone
914-219-119-1062 Fax
STATE WIDE INSPECTION SFRVICtS Email: offic:ODswisny.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 2 Jasmine Lane-Common Area-Adjacent to
Rye, NY 10580 2 Jasmine Lane
Rye Brook, NY 10573
Located at: 2 Jasmine Lane-Common Area-Adjacent to 2 Jasmine Lane, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP 22-194
129.25 1 1.46
Certificate Number: 2023-8516 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: 2 Jasmine Lane-Common Area-Adjacent to 2 Jasmine 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 20'h day of November 2023.
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.