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Angelo Zaccagnino DIECIEME
Q.O.B: 1211111968
F�Rnu
Company: BUILD DE _fi MENT 5EP 2 2 2022
Zaccagnino Electric
81 Maple Avenue VIL E OF RYE OK
Rye,NY 10580 938 KIN ET RYE B ,NY 10573 VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
tense No. 755 �
OI
Aires on:92/3112022 Peter Borduccl
r,L1E+JCTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required //
FOR OFFICE USE ONLY BP#: EP#: CDQ--�'3C,Q
Approval Date: Permit Fee: $ A16d I.,
Approval Signature: Other:.
Application dated, �'/ 7 Z Zis 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: `ict o ICh SBL: /-- If c)7 /—(y Zone:
All Property Owner:LL,n / P Address: 134,
Phone#: �l r`�r 37� 06700 Cell#: email:
3.Master Electrician:AAq,[Dzc L-",l4�►�,19/0 Address: 7I Y 2gle, ave,I � 1055
Lic.#: 7, ' /]I
Phone#: qlq ` 13Aq Cell#: email: AAgelo0- 7-x46CAgA;Ab, Off,
Company Name: l Address:
4.Proposed Electrical Work/Fixture Count: 1�I�{Le (7l 1°X i T (mP,cT/focI -
5.3ed Party Electrical Inspection Agency: Is 4�
TATE OF 'W YORK,COUNTY OF WESTCHESTER ) as:
44/ e- 9 t! Arj being duly swom,deposes and states that he/she is the applicant above named,and does further
(p6nt nam6 of indivi ual signi g as the applicant)
state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is
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 befo a me this Swo t bef e t
day of `~ 0 2 day f
Sign tur of Pr erty wrier Signature of Applicant
Li
Print Name of Property Owner lrrint
F NEW YORK
u
No. 1 043a
NNtrt ° 7ExPife$
F NEW Y01W Notary 4rbdltlle A eatc esler Count
NO. 23� My Commission Expires ctober la, 201�
Qualified 1stet COYtit
My Commissionc ber 14, 28 6/23/2022
SEP 3 0 2022
BUILD ,. DEP . ' - MENT VILLAGE OF RYE BROOK
� BUILDING DEPARTMENT
VILLAU OF RYA�T- OK
938 KIN619 ET RYE BRo` ,NY 10573
' 939�t
wwv`r�ebroo .org
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP#: -'� EP#: ��` c_4
Approval Date: Permit Fee: S
Approval Signature: Other:
Application dated, 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: 136 `Sow �/Q'Y�� ,17Y�� SBL: Zone:
��/�./ �/,
2,Property Owner: � � �paL; J� � ir� j UC Address: 2_4'
Phone#: CP(4 Cell#: email:
3.Master Electrician: Address.
Lic.#: Phone#: Cell #: email:
Company Name: Address:
4.Proposed Electrical Work/Fixture Count:
5.3rd Party Electrical Inspection Agency:
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,ctc-►
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.
1
Sworn to before me this ZA Sworn to before me this
day of ', 20 day of ,20
(Signture of P perty Omer ty j Signature of Applicant
i
Pri t Name of P perty Opmer - Print Name of Applicant
Nora t Public Notary Public
I<rl_lY SAnin1.FR
fq�tary Pulit'n N!ew York
Cr U(ic:r-' in 6/23/2022
CornntlSGlon Expav's J9, L:Wp
INSPECTIONSTATEWIDE
Service With Integri(y
0•0
SWIS JOBAPPLICATION ■ 0.
Oflice Use Elect.Permit# 67A)CD `CD+3 j(� Date / z 7—
Bldg Permit#
Final Certificate#
City/Village i4c
III Zip p J township Count�(S
Address /3 r 1 Cross Street Section Block lot
Owner Name✓/�Address(If different than above) ContactNumbl/i� -1'3.7-6C?043
❑Basement ❑ 1st FI. ❑2nd FI ❑3rd FI. ❑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 1P 3P #Meters #Disconnect ❑Underground ❑ New ❑Reconnect
❑Overhead ❑Change
❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection
Additional Information ` 1 I
p IFC';1I 'I
SEP 2 2 2022
DD
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 anytime of inspection additional items have been installed,you are
aut hodzed 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
v authorized agent agrees to all the above terms and conditions asset Imh for the applkation.
Inspector Date Finalized 1 p for a
Company Nam e e6j, P J dc) I cr Date 'l�1 �� Si na are
Address City✓State Zip Code O J
License# Phone it IF/L(—
State Wide Inspection Services
11GAD11' 1080 Main Street
Fishkill, NY 12524
05 845 202-7224 Phone
wri914-219-1062 Fax
STATEWIDE INSPECTION SERVICES Email: offlce0swlsny.com
Website: www,swisny.com
Service With Inregriry
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
Zaccagnino Electric Win Ridge Realty
Angelo P.Zaccagnino 136 South Ridge Street
81 Maple Avenue Rye Brook, NY 10573
Rye, NY 10580
Located at: 136 South Ridge Street, Rye Brook, NY 10573
Section: Block: lot: Electrical Permit Number: EP22-236
Certificate Number: 2022-6139 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: 136 South Ridge Street, Rye Brook, NY 10S73
The Basement and First Floor were 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 11th Day of October
2022.
Name Quantity Rating Circuit Type
The Visual Safety Inspection of the Basement and First Floor were performed on October 11t",2022
and Complies with the New York State Code. No Defects Were Noted.
fJ"rs -
a
Officer: Frank t. 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.