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ENT 3D
VIOK MARL920J231
938 KINNY 10573VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
__ _
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP#: EP#: pl 9
Approval Date: 8IR ���nt Permit Fee: $
Approval Signature: Other:
Application dated, 02 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: l� t-e_Lx:j e_ . SBL: �� � —�"�� Zone.e_'�—�
2.Property Owner: Address:
Phone#: Cell#: -
3.Master Electrician/Licensed Installer:
Address:.
Lic.#: Phone#: 6-D&1#1 Lq 7(oO— C) Q email: �.,Vy Cr-el (PA,L r
Company Name: I 1] 12— I t��LC, e . Address: ��}5
4.Proposed Electrical Work/Fixture Count: C)%�3
4
k
5.31 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 ignin€,as the
state that(s)he is the �l(It I� t(� d i for the legal owner and is duly authorized to make and file this application.
(Master Electrician/Licensed Installer)
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 A� Sworn to efore me this V
day istt�'
20 3 day of ,20 c�3
Si f Property Owner a of Applicant
PnVlame oj ropertm Owner Print Name of Applic ,
-Kota _Public LISA txclocclo __ to P�t l�l�10
Nd*v Nbk. 3tete of New Yolk LISA i
No �{819030 �_ NotaN Pubrro • date of New York
No.4819030
Cer iflopte FAe In Westchester^,.otm l/ CenMr to File In Westcnester amour
CommLwlon ff f 3f 1R0'—t(' Commission Expir" 7/3) �P'('p 3/3/2023
INSPECTIONSTATE WIDE
Service With Integrifty
1.1 i i
SWIS JOB APPLICATION1 16 • •
Office Use Elect.Permit# 3- Date
Bldg Permit# Sq Ft
Plumbing Permit#
Final.Certificate#
City/Village-Rvte oc> Zip OS 13 �BuildingDept'
County UCH S-T—
Address I �� Cross Street Se�Eiq` ��j Bicl / �t of
Owner Name/Address 41fferent than above) C' Contact Number k�
Basement ❑ 1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic Outside Residential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact
Amt Amps
Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch
SERVICE
Amperage #Panels q
P r Meters ~Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair
❑Overhead ❑ Upgrade ❑ Disconnect
Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland
PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
Legalization ❑ Safety Inspection ❑Consultation
�r1 e ova O 'P-oo &Rp 0\�Q kc)-A "c>�\JLCOEZ..
F� '�!7 J, I E D DD
i
MAR - 9 2Q2�
I
VILLAGE OF RYE BROOK
BUILTNG DEPARTMENT
This application is valid forone(11 year from the date received Isy 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
authorized to make the inspection and adjust the fee for the additional items inspe ted.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 ahcme terms and conditions as set forth for the applicatiun.
Email Address , I' ,, NameTej f
License# I fry a Date skak; Signature.
Address I —y— e e-4 Gty/State r0 V ti e- *-r, N Zip Code p
Company 4L4� r - 't Phone#
R
�`J� 1h,
State Wide Inspection Services
cjk--:> 1080 Main Street
Fishkill, NY 12524
4Au"7 MAR 21 2023 845 202-7224 Phone
914-219-1062 Fax
STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: offlce@swisny.com
BUILDING DEPARTMENT 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:
La Bella Electric Inc. John & Kristina Salov
Jerry La Bella 15 Highview Avenue
145 South Main Street Rye Brook, NY 10573
Port Chester, NY 10573
Located at: 15 Highview Avenue, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP23-059
141.35 � 11
Certificate Number: 2023-1843 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: 15 Highview Avenue, Rye Brook, NY 10573
The Basement and Exterior 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 21st day of March
2023.
Name Quantity Rating Circuit Type
Service 01 200AMP
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.