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HomeMy WebLinkAboutEP23-141 a a : s a a e'er M N N a, 1--5 cn W M }"y O 00 'o A O Z +� ►x oW A O o � w N o a w z U N W cn W c1 0 00 O F.W Ln U w w e CA� rn CD A w u z � z 1 -1 o H '4 z z w rn z F-1 I : � A a A~ � w � w W W © z z o 2 . � W V � g ,.., w z 609- x 0.4 ° .. a w �I 1-4 D EC ENE BUIL E . iyl ] B MENT ��� 2 0 2023 VIL C.O>'RVJE _ OK VILLAGE OF RYE BROOK 938 KIN ET RY.L:B NY 10573 BUILDING DEPARTMENT 'n .csr ELECTRICAL PERMIT APPLICATION Westchester County�tEltrieians License Required f FOR OFFICE USE ONLY 11P#: EP#: ZD3 Approval Date: 12023 Permit Fee:S _c� ) 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 an /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:._ p / (�drG+FieS4- . �/�� l3l? �y SBL: Zone: l� 2.Property Owner: yG 14,6/ el e q Address: W JLG O&VA4A, ryf Phone#: Cell#: mail: Sy/v+;L Of&" A/kI emwl 3.MasteraEllectician: r (9Wt+jr wAei' Address: ,, Lic.#: 3 Phone#: — O AA Cell#: �/ -wl-' lr email: lyj A "V �4VA�,ev Company Name: Aj L z6(;/t'L Address: Al §&j/he o� A/` i 4.Proposed Electrical Work/Fixture Count: 5.31 Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: SrAI K-, ,being duly swom,deposes and states thaoi she is the applicant above named,and does further (print narne of individual signing as the applicant) state that(s)hc is the legal owner of the property to which this application pertains,or that(s is the C V n+,t C-lz9/ 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 aft statements contained herein are true to the best of his/her knowledge and belief,and that any wrork 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 spec� patlbH[ Ia)y}yell as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of RKt�` oklanft ,applicable laws,ordinances,and 6regulations. !-� 'N0TARy •'Pi ''. Sworn to before me this c�V f''G� Sworn to before me this da of 2 ;4_N� 01 R48918853'•rn= day of�,�,,� 20,�� 4UALIFIEO IN :WESTC►+ESTER COUNrr: COMt,A. EXP Signat' roperty O�wn ; ,p*'. 08-16-202A = Sig� re of Applican Print arc of Property er ''�i,,rOP N Et�l'`W Print a of Applicant Nola c LNAX Pub ROSEMARIE A KOZERA Notary Public - State of New York NO. 01K06216,660 Qualified in Westchester C unty6rz flo ^.w ( nmm ssin� Expires STATEWIDE INSPECTION SERVICES, INC. 6C) Service Willi fritegrity 0:0 SWIS JOB APPLICATION0. Office Use Elect.Permit# � f�� Date Bldg Permit# / Utility IIDy#�/d O+ Final Certificate# City/Village ��� zip �O Township County j#,'eJ{4,vf/4 r vx AddressrS1 !_Jf_r d�,�— Cross Street Section 2 3� Block 7y 4 r 6►' Owner Name/Address(If different than abov- W [t_I[l uC_ Contact Number ❑Basement 1st FI. ❑2nd FI ❑3rd Fl. ❑More Than 3 FL ❑Garage ❑Attic 0 Outside /❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact Amt Amps Range(s) Cocktop(s) Oven(s� Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage tP 3P #Meters #Disconnect ❑Underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information / r Tq /Y t A4J7 D.� e r c1 /467 Y / df e-.1 / ar Jam' 4 D [EC 10d E ID J U N 2 0 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(1)year from the date received by sW6.This apphcahon is intended to cover the above fisted items to be inspected,if at any time of Inspection addulona!items have been Installed,you aae authorized to make the inspection and adjust the fee(of the additional items inspected.The applicant declares that there Is no open applications for the above address with arty other Inspection company.The applicant,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name A / 41muffl(a Date /r Z Signature Address S f City/State 7�i// Qr/ X- ion 2- License# Phone# �� D JD State Wide Inspection Services J U N 2 8 2023 1080 Main Street Fishkill, NY 12524 a 845 202-7224 Phone VILLAGE OF RYE BROOK 914-2194-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: officeLd)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: ADT Commercial LLC Rye Hotel, LLC 6 Skyline Drive 699 Westchester Avenue Hawthorne, NY 10532 Rye Brook, NY 10573 Located at:699 Westchester Avenue, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP23-141 135.74 Certificate Number: 2023-4794 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:699 Westchester Avenue, Rye Brook, NY 10573 The First Floor 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 281h Day of June 2023. Name Quantity Rating Circuit Type Horn/Strobes 05 Visual Inspection Only; Not Tested by SWIS. 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.