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BUIL E MENT DD
VEL E OF RYE OK NOV 3 0 2021
938 KIN ET RYE B ,NY 10573 VILLAGE OF RYE BROOK
(914)9 939-5801 BUILDING DEPARTMENT
.or _ _
ELECTRICAL PERMIT APPLICATION
Westchester County Master Electricians License Required FOR OFFICE USE ONLY BP#: EP#: —,3 /I
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Approval Date: DEC — 2 2021
Approval Signature: N Permit Fee: S Z�
Disapproved: Other:
(fees are non-refundable)
Application dated,// ,3 D Q1 is hereby made to the Building Inspector of the Village of Rye Brook NY, for the issuance of
a Permit to install an or remove electrical equipment, wiring, fixtures ,or to perform other high or low voltage electrical work as per
the detailed statement described below. The applicant & property owner, by signing this document agree that all electrical work
performed will be in conformance with all applicable Federal, State,County and Local Codes.
I.Address: Z�R 1el[A 1,r 1�,r0c d, lW, CxC4 SBL:1 21�4,'45-- I Zone /duV
2.Property Owner: f 60 no a. Address: T_Lo &--tW-4C(t r oad, +(,r� _ Grocl)''
Phone#; �{(fir , � `Stil( Cell#: email:f73 q
3.Master Electrician: eri i Address:
Lie.4:6 Phone#: Cell#:J I�� 77--n email:
Company Name: f t EQQ1J etC Address: Sh
4.Proposed Electrical Work/Fixture Count:
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
Qk ,,:�p Ieju a ,being duly sworn,deposes and states that he/she is the applicant above named,and does further
(print name otindividual signing as the applicant) p
state that(s)he is the legal owner of the property to which this application pertains,or that(s)he is the F(,(n� c� cNl
for the legal owner and is duly authorized to make and file this application. (indicate architect,contractor,agent,attorney,etc.)
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 Wu Sworn to befor me this mb y
day f 20 day of Z 20 Z-
StgnatufF of Property Owner S' ature plicanyl
Print l me o roperty Owner Prin,Y a o�ra►pplicant
O he / No i9opher M.Bova
Christopher M.Bova {� lotary Public,State of New York
Notary Public,State of New York ho.01 B06383345
01 B06383345 ! ed in Westchester County
ii.ed ig)Westchester County _.Jn Expires November 13,2022
November 13,2022
1/5/16
STATEWIDE INSPECTION SERVICES, INC.
Service With Ittlegrity
0•0
SWIS JOBAPPLICATION0.
Office Use Elect. Permit# Data! --30
Bldg Permit# Llility ID #
Final Certificate If
City/Village Zip Townshi - Cou t
Address j l �t �p Cros tr t c o Block Lo
Owner Name/Address of different than above) &U'+ Contact Numb qii,
2 h?
❑Basement ❑1st FL ❑2nd FL ❑3rd FL ❑More Than 3 FL [:]Garage ❑Attic ❑Outside idential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact
Amt Amps
Range(s) Cocktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw
Incandescent Fluorescent
SERVICE
Amperage Voltage t P 13P #Meters #Disconnect ❑Underground ❑New ❑Reconnect
❑Overhead ❑Change
❑Visual Re-inspection ❑ Safety Re-Inspection ❑ Re-Inspection
Additional Information
G .� trsic:., C0yyT6Q 0rn{�
NOV 3 0 2021
I --_
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,avmer
or authorized agent agrees to all the above terms and conditions as set forth for the application.
Inspector Date Finalized Inspector#
Company Name ( ` e '� G Date Signature
Address y nnn I o City/State j� Zip Code
License# s k a Phone# L/� _ZI y)
State Wide Inspection Services
1080 Main Street
Fishkill, NY 12524
845 202-7224 Phone
914-2194-219-1062 Fax
STATE WIDE INSPECTION SERVICES Email: officeAswisny.com
W
Service With /ntegNty ebsite: www.swisny.com
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
Spirelli Electric Inc. Amand & Ravi Jha
Patsy F.Spirelli 26 Bellefair Road
990 East Main Street Rye Brook, NY 10573
Shrub Oak, NY 1OS88
Located at:26 Bellefair Road, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP21-314
124.73 � 59
Certificate Number: 2022-0057 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:26 Bellefair Road, Rye Brook, NY 10573
The Garage 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 7th day of January 2022.
Name Quantity Rating Circuit Type
Tesla Wall Connector 01 50AMP
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.