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BUILWNG DEPARTMENT3D
VILE OF RYE BROOK EMAR 2024
938 KING( FEET RYE BROOK,NY 10573
(44) 9-Q668 VILLAGE OF RYE BROOK
w xvx\.ryebrook.org BUILDING DEPARTMENT
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: C �-O q's
Approval Date: MAR 1 4 2024 Permit Fee: $ / —7\5 — P
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
T TAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF$750.00
Application dated, 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: ) &XYe k r" / —7
SBL: /35-t /3��—� 7 Zone:
2.Property Owner: (>7��C Spa ll v ear Address:
Phone#: Cell#: S n- E C)� email:
3.Master Electrician/Licensed Installer: 7 r1
// LAC �Wv Address: S�nCah�
Lic.#I76q Phone#: '7 0 CT Cell#: email: 7fY,�d�����'�e/ee'HYC U-C (?7%:W,
Company Name: Address:
4.Proposed Electrical Work/Fixture Count:
C"jtiC 641 1 tic C��r�`�a� fv ��1e �lydz-r'
ZCV 411f
5.31 Party Electrical Inspection Agency: SLy; S
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 name of individual signing as the applicant)
state that(s)he is the 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 mq this Sworn to before me its \�
day f A( � 20 day of C� ,20 aS
P ope er Signature of Applicant
SHARI MELILLO �B ' C tyey 1'
3name of Property er Notary Public,State of New York Print a 5T Applicant
No.OIME6160063
Qualified in Westchester County^
Notary Public Commission Expires January 29,2 _ otary Public
10/30/2023
STATE WIDE INSPECTION SERVICES, INC.
Service With litlegriq
0•0 • •
swis JOB APPLICATION0. •
Office Use Elect. Permit# L Date-Tql�s S/1
Bldg Permit# Scl Ft
Plumbing Permit#
Final Certificate#
City/Village Zip I �7'J Building Dept. FyP 6'ra::5 /� County
Address I P f � Cross Street Section Block Lot
Owner Name/Address(If different than above) Contact Number
❑Basement ❑ 1st FI. ❑2nd Fl. ❑3rd FI. ❑More Than 3 A. ❑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 1PP� 3P #Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑Repair
�i ❑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
ESE WI
--- ---,
MAR 12 2024 Di
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,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 as set forthfor the application. /�,� �-r t��
Email Address �rG(12JV/ ,IWe1Pe-�Y)CLk MCtt eCM Name ( �v,/fc "YG
License# ' 7 6 Date Signature
Address 7 Cr Prr')t/rcf City/State _ 1'-1 671)r I Zip Code 0CQO�
Company I,,�T (/ 'V rt e r ! l Phone#
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State Wide Inspection Services
MAR 1 3 2Q24 1080 Main Street
Fishkill, NY 12524
as%V US 845 202-7224 Phone
VILLAGE OF R`>'c BROOK 914-219-1062 Fax
STATE WIDE INSPECTION SERVICES BUILDING DEPARTMENT Email: officeCcbswisny.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:
Grandview Electric, LLC Marc Schlueter
Roy Duckworth IV 1 Sunset Road
87 Greenleaf Drive Rye Brook, NY 10573
Stamford,CT 06902
Located at: 1 Sunset Road, Rye Brook,NY 10573
Section: Block: Lot: Electrical Permit Number: EP 24-043
135.73 1 24
1
Certificate Number:2024-1563 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 Sunset Road, Rye Brook, NY 10573
The First Floor and Exterior were 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 13`h day of March
2024.
Name Quantity Rating Circuit Type
*Replaced 200AMP Master Service& Meter Only
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.