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BUILDIN61)9PARTMENT U i
VIL AGE OF RYE ,OK
93$KING�, ET RYE B ,NY 10573 JAN - 5 202�4
vv�uw or VILLAGE OF RYE BR��OK
BUDDING DEPARTMPN1
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required �q�j
FOR OFFICE, USE ONLY BP #: EP#: / �`�./ !
Approval Date: I ' ti L— ZO X. y Permit Fee: $
Approval Signature: - `� �_.—_ Other:
DO NOT START WORK or CONSTRUCTION UNTIL A PERN11 1 11:1ti BEEN IISSUE0 131 11TIE BUILDING INSPECTOR.
THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12ye OF THE
TOTAL
/COST OF('ONSTRUCTION WITH A MINIMUM FEE OF$750.00
Application dated, 7 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 tow 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/ k�Coddes. [ !! �//
1.Address: 6 Berkley Drive, Rye Brook, NY 10573 SBL: /JJ'137—/—yS- Zone:
2.Property Owner: George Chacko Address:6 Berkley Drive, Rye Brook, NY 10573
Phone#: 585-615-9523 Cell#: email: georgechacko@gmail . com
3.MastcrElectrician/LicensedInstaller: Michael P . Nizzardo Address120 Allen Street, Stratford, CT 0662.
Lic.#: 1724 Phone#: 203-378-0667 Cell#: email: philip.nizzardo@nandselectric.cc
Company Name: N&S Electric, Inc. Address: 120 Allen Street, Stratford, CT 06615
4.Proposed Electrical Work/Fixture Count: Installation of 60Amp EV Charger in Garage _
5.31 Party Electrical Inspection Agency: SWIS
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Michael P. Nizzardo ,being duly swom,deposes and states that he/she is the applicant above named,and does further
(print name of individual signingas the applicant)
state that(s)he is the Ma S e r k�1 e c t r i e i an for the legal owner and is duly authorized to make and file this application.
(Master Electrician J 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 Sworn to bef e this �
day 20 day of 4 20_ _
Si naitgre of Property Owner S' ature of Applicant •
Michael P . Nizzardo
Name of Property lQwner Print Name of Applicant
& ,(State of New York
Notary Public.Slat®ot Zjecbct40 0/2023
No.01ME6160063 My Commission Exphof -20 Qualified In Westchester County
Commission Expires January 29,20Dn
STATE WIE)E INSPECTION SERVICES, INC'
Service With Integriq
,:0 • •
APPLICATIONSWIS JOB 0. •
Office Use Elect. Permit# �� �� j Date
l 1.
Bidg Permit# Sq Ft
Plumbing Permit#
Final Certificate #
City/Villages Zip "? Building Dept. County
Address z r Cross Street Section Block Lot
Owner Name/Address(Ifdifferent(,an above) Contact Number 57�C_ /lCal - q�^
❑Basement 0 1st Fi. ❑2nd FI. ❑3rd FI. ❑More Than 3 FI. l�Garage ❑Attic ❑Outside ❑Residential ❑/JCommercial
Receptacles Special Recept GFCI AFCI Switches !'—Diimmers Smoke Alarms C/0 Detector Hood Trash Compact
Amt Amps
Range(s) Cocktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch
SERVICE
Amperage Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair
W
❑Overhead ❑ Upgrade ❑ Disconnect
Utility ID# ❑Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland
PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
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,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 abo �ddr ss with an they inspection company.The applicant,
owner or authorized agent agrees to all the above terms and conditions asset forth for the application.
i
Email Address Z / �� Named
License# Date L Signature
Address /11 City J State 5 Zip Cod
Company �' Phone #
L� !' L �'
� i State Wide Inspection Services
1080 Main Street
2 3 ZQ24 `--' Fishkill, NY 12524
swuss
���'-�_�� I 845 202-7224 Phone
VILLAGE (Jf �'E BROOK 914-219-1062 Fax
STATE WIDE INSPECTION SERVICES 11 G I Email: officeCalswisny.com
lE: -!:i --L -rNT Website: www.swisny.com
Servlce With Integrity
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
N&S Electric, Inc. George Chacko&Jincy Thankachen
Michael P Nizzardo 6 Berkley Drive
120 Allen Street Rye Brook, NY 10573
Stratford, CT 06615
Located at: 6 Berkley Drive, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP 24-009
135.34 1 45
Certificate Number: 2024-0317 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: 6 Berkley Drive, Rye Brook, NY 10573
The Garage and 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 19`h day of January 2024.
Name Quantity Rating Circuit Type
EV Charger 01 60AMP
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.