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HomeMy WebLinkAboutEP23-221 6 � s N � \ o H O A � 0-4 a 0.-0 w w x °0 0 W o N w r : L4 Z �1 oo A w 'P'o V © m �--� cs W H o A cn H a PLO \� _ ,14 - ll cx, FBI M U z A 5 w� Cn u U W w O 7 W E-� CZW7 O z © V}Z vy U u w z 00 0 � A Q z a cM z C Q W z H oA 0 w � BUIL E ANT OCT - 6 2023 VIL E.OF RYE OK 938 KIN ET R'YFB ,NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT or ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required / FOR OFFICE USE ONLY BP#: EP#: Approval Date: (�� 0 ^;^ Permit Fee: S Approval Signature: Other: Application dated, 10/3/23 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. 1.Address: 938 King Street s SBL: Zone: 2.Property Owner: Village of Rye Brook Address: 938 King Street,Rye Brook NY 10573 Phone#: Cell#: email: 3.Master Electrician/Licensed Installer: Awni Naber Address:1025 Saw Mill River Rd,Yonkers NY 10710 Lic.#: E-1 Phone#:914-941-2244 Cell#: 914-760-5326 email:ajuamaberelectric.com Company Name: Naber Electric Corp. Address: 1025 Saw Mill River Rd,Yonkers NY 10710 4.Proposed Electrical Work/Fixture•Count: Install(1)Electric Car Charger 5.3"Party Electrical Inspection Agency: STATE WIDE INSPECTION SERVICES �,��**�,�x,�**x:�,�xx*�*x,�xxx:�*x,���*��xx*����*�*�,�,�,�**�,����*:*�xx;*x�*�;;x,•�x������x**����;;���,����F��xx���*,�x STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Awni Naber ,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 Mater Electrician 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 Swo t be rem this ' day o 2 da f S' nature of ro erty Si atur of App t ^ ' ' IN 14 t Vow' Print Name of Prope rty O 6�ter in`` ��� ota blic 6286353'••Z ry — FLED IN .rn= GREGORY M.RIVERA _ t:Ts LINTY: Ndary Public,State of New York co 29-202 No.91R16411298 f�'�rr�gj'•?U(3LlG.•''pQ���� 3/312023 Quarted In Westchester County Cormrftsion Expires Septembers 26 201 //`�'� i�l 11M%0��`,` STATEWIDE • Service With Ittlegril-V I81 Main Street, Fishkill, NY 12524 1 email:office@swisny.com SWIS JOBAPPLICATION tel845.202.7224 I fax9l4.219.10621 SWISNY.com I SWISTraining.com Office Use Elect.Permit#��� `��` � Date Bldg Permit# Utility ID# (D Final Certificate# Ci LVII lag Zip Township County i"' Address } Cross Street Section Block Lot .e l Owner Name/Address(if different than above) (� } Z_ Contact Number ❑Basement st FL ❑2nd FL ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic '-_2"butside ❑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 Ajskn OCT - 6 2023 ID VILLAGE OF RYE. BROOK BUILDING DEPARTMENT This application is valid for one n)year from the date received by 5Wls.This application Is Intended to cover the above listed items to be Inspected,M at any time of inspection additional hems have been installed,you are authorized to make the Inspection and adjust the fee for the additional hems inspected.The appikant declares that there Is no open applkations 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. Inspector Date Finalized Inspector# Company NameIiV � DateOSSignature ,E,C_ I f , Address 0 Z ��� t 1( ? ,t,r 1 City/State Ya")r_` Zip Code License# if-_� Phone# I 1 Z Z