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HomeMy WebLinkAboutEP24-004 ■ C f s � Le) W IlzrlLn Lin N C ■ = W Tyr �j � 4-4 �.1 ■ 04 DPCy v, v - = Rom, cnw BTU M W m ■ F-�-1 r� � � A � bq !1y a ■ ill L; v H a M M a V) i� a = O Lr) Rai O W A = O �[� F4 w .a ■ 1.0 ■ O ..v w U _ 1— Q p z 9 -'J `� �l A z ■ 00 ° V � p two o � z � � z zcn -�. a z — 00 o �D - r7] �1.0 w � ° " WU .+ b-W O O w © z o - LnV x w 00� 1.0 a w � � CA 6 00r , $UILENTVIL OK DEC 2 9 2023938 KIN , NY 10573 VILLAGE OF RYE BROOK BUILDING DEPARTMENT ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: C:-,) / ' / Approval Date: 1� Permit Fee: $ / '` _/`- Approval Signature: Other: Application dated,_�alog a_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: G q l Qe— SBL: I36'f 16—/'_30 Zone: 2.Property Owner: \C C Yl Address: 1 wccd-bf. %g7b(00�1 OS 7.3 • Phone#: q I J - 'q 5O Cell#: i l - p email: Z 1.JI, 3.Master Electrician/Licensed Installer: -2fY l�v>� oa_ Address: 1 4S ill�In ee_+ —po✓ Lic.#: E 114 Phone#: 1 050 t Cell#:atA1_+-A©$© email: ce es �,. 1 � W Company Name: ,Q c J�LL. Address: 14Syl �C(PP 4.Proposed Electrical Work/Fixture Count: --P""+ Cite �t V 5.31 Party Electrical Inspection Agency: STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: being duly sworn,deposes and states that he/she is the applicant above named,and does further (print ham(;'individual i_S'gning�a�apQl'ct ant) state that she is the � V't t±loLq 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 C Sworn to before me this day of Qr 6 20 .3 _ day of D p� Lf ,20 14 Signature of ProWerty n of Applicant 'qa�ry kz Pt f t __ Print,Name of Property er Prin ame ppl' ant 1 �O 1 i 46taff Public o Public lr f lSA !O r LJ91101CKXXV 1 Notary P SA •a`tate of New Mork 1o"V Public *ate of New folk No. 1819030 Nc 4819030 Certincz,e Rio in Westchester nty/ Rle r 'Ne&tcnest; Courtly 3/3/2023 6 COrfNrriMlow Expires: Commission Expires. 773/ , '7l3ijA. 4& STATE WIDE INSPECTION SERVICES, INC. 0:0 • • SWIS JOB APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNY.coml SWISTRAINING.COM Office Use Elect. Permit Date Bldg Permit# Sq Ft Plumbing Permit# Final Certificate # City/Village X j�'�� Zip Building Dept. County Address Cross Street Section Block Lot Owner Name/Address(If different than above) _ �� Contact Number asement ❑ 1st FI. ❑2nd Fl. ❑3rd FI. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer switch SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑ 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 vz �D FrEC 2 9 2023 VILLAGE OF RYE BROOK BUILDING DEPARTMENT This application is valid for one(t)yearfrom the date received by sW)s.This application is intended to cover the above listed items to be inspected,if at any time 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 asss set tfforth for the application. Email Address Name License# Dat 2 v�-23 Signatur Address City/Sta L� Zip Code fC�5 Company� r'�fG�� Cr%�� Phone# 51�j Qv `" State Wide Inspection Services C > 1080 Main Street JAN 12 2024 Fishkill, NY 12524 swis 845 202-7224 Phone VILLAGE OF RYE BROOK 914-219-1062 Fax STATE WIDE INSPECTION SERVICES BUILDIi`<r,_ ncr ARTI`�!ANT Email: office(a)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: La Bella Electric Inc. Theresa Zampaglione as Trustee of the Jerry La Bella Ciccone 2014 Irrevocable Income Only Trust 145 South Main Street 1 Edgewood Drive Port Chester, NY 10573 Rye Brook, NY 10573 Located at: 1 Edgewood Drive, Rye Brook, NY 10573 Section: Block: Lot: Electrical Permit Number: EP 24-004 135.36 1 30 Certificate Number: 2024-0102 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: 1 Edgewood Drive, Rye Brook, NY 10573 The Basement 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 10"' day of January 2024. Name Quantity Rating Circuit Type GFCI Receptacle 01 *Removal of Electric Strip and Wiring Violations 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.