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HomeMy WebLinkAboutEP23-222 . _ N w O ' W Ewa W = ,, en `nen o s . Lr) Who Z z N w C _ z o 0 A N O .., Ln00 o R� a L co : F �--� z r o A � z � w � • W ^ � 00 � ON � V N cy� ,',► Gn , _ © U V U W w O 0 a Ln V o w o N A w 0 _ I as a a z w xCA 5ECEWE BUILDING DEPARTMENT VILLAGE OF RYE BROOK OCT O 2023 938 K1NGkSTrtE T RYE Blue,NY 10573 VILLAGE OF RYE BROOK (914)939=066�'`, BUILDING DEPARTMENT www.rydr�.org ELECTRICAL PERMIT APPLICATION Westchester County Master Elec ricians License Required FOR OFFICE USE ONLY EP M C � ' Approval Date: OCT 1 D 20 S #: Permit Fee: $ Approval Signature: Other: Application dated, f0 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. 1Address: G 1oO AJ Zy (-- J Zone:/ J 2. — Property Owner: �L.�E%� ( J f E� Address: Z Z MAV V ,ey,4-tJ'a�/f NV1D 73 Phone#: d 51S7 Cell#: f I V 3S6 3r/5;7 email: 1-tikiyMYC-4LTo 62�1 Jae 60^1 3.Master Electrician/Licensed Installer: n"11414 U L-L C-r PrL(N D C) Address: - ip pp.57 Lic.#:� I Phone#:�1� 5 Z1 ZFid Cell#: �/V ?,Q V 510 Zf email: AA"VMY 6Ot-F� 6-) NI Company Name:g V E j- E(r G7'7Z I C Address: 3 t D f o 57- Z Pf . M fVkt I�IZQ�CI� 4.Proposed Electrical Work/Fixture Count: K 6FIylO(1 E L-'L C C riz(c L--3E72 U r C t` T O �y A 5.31 Party Electrical Inspection Agency: 7LJU STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly swam,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 rnANJ)F 1.._ 25�-4( /ILt_TJ,O 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 Codeof the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to b fore,me is V Sworn to befo e e this day o 20 day of 0 20 `Signature of Property Owner Signature t �LpC o FEZ- t P ' t ame of Prope (*ner ame of Applican r Notary lic ✓ Notary Public GREGORY M.RIVERA SHARI MELILLO Notary Public,State of New York Notary Public,State of New York No.DIR16441398 No.OIME6160063 3/3/2023 Quafified in Westchester County Qualified In Westchester County Commission Expires September 26,2� commission Expires January 29,20 LL STATEWIDE INSPECTION Service With IntegritY 0:0 Main Street, Fishkill, NY 125241 emoil:officeCpswisny.com SWIS JOBAPPLICATION0. Office Use Elect. Permit# ^1 \ � Date/ � �"s Bldg Permit# d C� Utility ID## Final Certificate# City/Village \/ 11� Zip /0 5 73 Township County Address G Z f.1 �l'I ,n ! A lV E Cross Street Section Block Lut Owner Name/Address(if different than abov« L./� / p Contact Number / 1 6 57/ C 7 ❑Basement ❑ 1st FI. ❑2nd F1 L�❑[�3rd FI ❑More Than 3 FL ❑Garage ❑Attic ❑Outside f Reesidentlal ❑/Commercial Receptacles Special Recept GFCI AFC! 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 t P 3P #Meters #Disconnect ❑Un ground E]New ❑Reconnect Z—00 fZe?pgp Overhead Change Visual Re-Inspection ❑ Safety Re-Inspection r� ❑ Re-Inspection Additional Information OP(51.1t DE �X�57'/��T���;' / T- r Cj/CE 2 OCTID1 10 2023 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,it at any time of inspection additional items have been installed.you are authorized to make the inspection and ad(ust the fee for the additional items inspected-The applicant declares that the+e is no open applications for the above address with any other inspection company,The appllsartt,owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company NameY� Date .—/l —.,7 Signature Address 010 { City/State �/7 rt//'� Zip Code IO C5 Y' , ��[.Jnt' License# Phone# t ' Q p CAC> DState Wide Inspection Services 1080 Main Street I NOV 2 9 2023 Fishkill, NY 12524 �,_._",_ 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTIONS RVICtS BUILDING DEF-ARTMENT Email: office()swisnv.com Service With Integrity Website: www.swisny.com BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Upon Premises Owned by: Rye 1 Electric Elder Lopez 39 Old Post Lane 22 Maywood Avenue Mamaroneck, NY 10543 Rye Brook, NY 10573 Located at: 22 Maywood Avenue, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP23-222 135.75 33 Certificate Number: 2023-8603 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:22 Maywood Avenue, 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 29"'day of November 2023. Name Quantity Rating Circuit Type Service 01 200AMP Meter 01 Panel 01 Grounding and bonding of service to current codes. Officer: Frank 1. 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.