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HomeMy WebLinkAboutEP23-082 , oNiO ' N 4- N Ra t � W W S H z W � (� cz W w ( W � z A Nr in ^ ~ _ W °eq w z H Im* 00 Q v Rt 0 co 00 H y O W z O C� So � U' z wz (> °° w 00 cx o z ,-1 w w z o ° � arj) ,, c Z o cn O a <C U No z A oAw x Ox U un W o ff �I aca a w x � r rFr BU1L, EI3r * MENT " MAR 2 0 2623 VIL a of RYE OK 938 K]N IZ 'I B NY 10573 ` VILLAGE OF RYE BROOK BUILDING DEPARTMENT wthc ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: Approval Date: APR Q 5 Permit Fee: S - Approval.Signature: Other: Application elated, is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remote electrical equipment, wiring, fixtures,or to perform other high or low Voltage electrical work as per the detailed statement described below. By signing this docume rtt, the applicant & property owner agree that all electrical work perfonned will be in cotnfomrance H itii all applicable federal,State,County and Local Codes. r 1.Address: I'�1 1 1• SBI_: ! S !y Zone:le.�L` 2.Property Owner: Address: ` r 3, z -L `—1 Phone#: Cell#: email: 3.Master Elcetrician/Licensed Installer: M 1 Address: � '►1. Lic. #eyLlL{L Phone#:C9f —�l{��- U� [ell tu: �� emailii l`!:•� (; c>01 T r Address: Company Name: 4.Proposed Electrical Work/Fixture Count: 1 C V Q- S LC�/s 5.bTa Party Electrical Inspection Agency: ****ieh*************it*�r•k*************h**hie******iF k***********aFlt***.u***********#iehwit ir,P,t*•k*****ht.i:t**x i:hieh:kk ` �� STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: t"`% Pp _ ,being duly swam,deposes and states that hetshe is the applicant above named,and does further �I V lrtpr m ehslt f'individ+r I.'t nj� +.:the a III -in state that lslhe is the v_ for the legal owner and is duly authored to make and file this application. (Master Electrician'Licensed Imtailco The undersigned further stales that all statements contained herein are true to the best of his/her knowledge and belief,and that any)1vork performed,or use conducted at the above captioned property will be in conformance with the details as gel forth and contained in this application and in any accompanying approved plans and specifications,ac 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 fD Sworn to before me this day of ,2U_ _ day it f ,20 � -- Signat�irre ofof Property Owner i1 igna trr of Applicant Print Na A,of rop rty Owner Tint Name of Applic tNOTAXY ANCOHN j,& GARCIA tate of New York C,STATE OF NEW YORK #t71 GA6198885nNo 01CO6227230a in�TassauCotuuy stchester County 1A12023 1 KE Cs Aug» 30,20 C fires January 5,20 STATE WIDE INSPECTION SERVICES, INC. Service With Integrity 0:0 • • SWIS JOB APPLICATION tel 8415.202.7224 1 fax 914.219.1062 1 SWISNY.coml SWISTRAINING.COM Office Use Elect. Permit# 3 Date Bldg Permit # Sq Ft Plumbing Permit# Final Certificate# City/Village �n—oD Zip/off Zip/off3 IBuilding Dept. A-AV County[ -k-L-)AAft Address L � I Cross Street ' f�l Section/jj �� Block �/ Lot 11 L) I L'I Owner Name/Address(if different'than above) ` 2 U Contact Number / ,,_07 3 ❑Basement ❑ Ist Fl. ❑2nd FI. ❑3rd FI. ❑More Than 3 FL [Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFC: 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 ]P 3P # Meters # Disconnect ❑Underground ❑New ❑ Reconnect ❑Repair ❑Overhead ❑Upgrade ❑ Disconnect Utility ID# ❑Con Ed 0 NYSEG ❑Central Hudson ❑ Orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation finis ll r cl�.� amp 1l� ��-- I IECE V/1[E APR - 3 2023 j 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 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 authorized agent agrees to all the above terms and conditions as set forth for the application. Email Address �U� f [� Name All C.�Ce License# Date l a Signature, `---� Address 7 ��� City/State Zip Code Company J D LE�C E �W E ! State Wide Inspection Services co" 1080 Main Street APR 2 4 2023 jD Fishkill, NY 12524 845 202-7224 Phone a VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT 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: Blume Electric Hedy Cardozo Michael B Blume 14 Holly Lane 59 Sunset Drive Rye Brook, 10573 Located at: 14 Holly Lane Rye Brook, 10573 Section: Block: Lot: Electrical Permit Number: EP23-082 129.59 � 34 Certificate Number: 2023-2690 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: 14 Holly Lane Rye Brook, 10573 The Garage 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 April 2023. Name Quantity Rating Circuit Type EV Charger Receptacle 01 50AMP 240V t�t. 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 tivork performed on the date of inspection only.