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HomeMy WebLinkAboutEP23-255 , : _ L , L M C'J N N W = M N N00 W , 04 1-4 W z W c, C/) 1-4 0-4 � O ^ cn cn �riLn z m `D c; ° "n 00 T-O Q4 o A A = O Lr) � © : O W Nei 1 b I1 A W LO ocow w w � cc (A z U z cn cn po C'N V A O O v Wz H H W U rZ00 ` cn ON A � � U U � U � w o 0 w 0 � w � U p BUILDING DEPARTMENT DEC 5 2(�23 VILLAGE OF RYE BROOK 938 KING STREET RYE BRoox,NY 10573 ( �4) 9-Otiti$ VILLAGE GF RYB B OOK BUILDING C�1=PARTMENT www.ry iok.org ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Require FOR OFFICE USE ONLY BP EP#: C-7�)13 Approval Date: Permit Fee: $ / 6-0 —Pz' - Approval Signature: Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BY THE BUILDING INSPECTOR THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF 5750.00 Application dated, I 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 1.Address: �' 1 , C- L i SBL:/3 66~`—SS Zone: 2.Property Owner: 6 t fl .Z, Z 9 � y, a wAddress: a 9-1h_ 1+i' 1' i. A C- 11 Phone#:� 1 `} h Cell#: mail: 3.Master Electrician/Licensed Installer: , 2�'-u G 0 p c Address: Sv u5 e t- RvA,/ Lic.#:6 S81 Phone#:QV-535 2`-/Z/ Cell#:0V-871)-5V2`i email:jL5fI fc dol,eorr II�� Company Name: lA1 e b`1lno&k U t t M L Address: G 5cj�)z ij7u,- P/3/o% {U y/Q s 73, 4.Proposed Electrical Work/Fixture Count: a,-4 L4� f I L uu 4 A 4,1 17 �aL 5.31 Party Electrical Inspection Agency: 5*w I ss STATE OF NEW YOM COUNTY OF WESTCHESTER ) as: O h U 6 k t-C C .being duly swum,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 a As ri1 0e c f A-i t,,*A,) 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 Wore me this kh Sworn to before this day of ` C ,t7 2 209: day f C .207 Signature of Property erg S0641rro Applicant � Q K8 `4)�'�1 I �1f� C_.r Print Nam oprophyOwner PrInnttaame o Applicant Notary Public ICHAEL ESQLIIVEL LNotary Public-State of New York Notary � RY M.RIVERA No.O1 E56442359 l0/30/2023 alified in Westchester County Ne"Public,Slate of New York ommission Expires Oct 11,2026 No.CiRI6441398 Qualifled In Westchester County Conrmisslon Eunires Sevtember 2A.?01 INSPECTIONSTATEWIDE Service With 1ijl1eqri1J 1;1 office(oswisny.com SWIS JOBAPPLICATION tel845.202,72241 fax9l4.219.1062 I SWISNY.com I SWISTraining.com Office Use Elect.Permit#C�� l� � 1 Date Bldg Permit# Utility ID# Final Certificate# City/Village Zip ,� Township County C Address Cross Street Section Block Lot Owner Name/Address(if different than above) Contact Number [:]Basement N[1st FI. ❑2nd FI. ©3rd FI. ❑More Than 3 FI- [:]Garage ❑Attic ❑Outside ❑Residential [:]Commercial Receptacles Special Recept GFCI AFC] Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact IAmt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P I 3P #Meters #Disconnect ❑underground ❑New ❑Reconnect ❑Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-Inspection ❑ Re-Inspection Additional Information r a'l {� I . I � DEC 1 2023 VILU, ,r Oi- i,. This application is valid for one Ill year from the date received by SMS.This application is intended to cover the above listed items to be inspected,if at any time of inspection additional flans 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 applcant,owner or authorized agent agrees to ail the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name ��4 rn ( ,��I C Date / Signature Address �� lr c� City/State � � j Zip Code 0ir, License# 3 1 Phone# e) y,9 2 g- y� R D 3D State Wide Inspection Services 1080 Main Street DEC 2 9 2023 Fishkill, NY 12524 845 202-7224 Phone 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: Westmore Electric Ronald Szczypkowski 6 Sunset Road 2 Bell Place Rye Brook, NY 10573 Rye Brook, NY 10573 Located at: 2 Bell Place, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 23-255 135.66 1 35 Certificate Number:2023-9158 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: 2 Bell Place, Rye Brook, NY 10573 The First Floor Laundry Room 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 20Th Day of December 2023. Name Quantity Rating Circuit Type GFCl/AFCI Combo 01 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.