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HomeMy WebLinkAboutEP25-054 c c w Ln Ln o A Ln F' : M V W .., v; "" m a,r CA N o c o y x • v cn W " a H HO W t� 00 +V W H w H Q � Oz w v en Cj W U 2 ��j s W �r rr1 M � z � � /� M-•+ rn � P� Q! � � � x � Q Q • CN Z a .. w Zall H oZ H x Z E CA w � eN-{ a � W a � BUILDING DEPARTMENT VILLAGE OF RYE BROOK Fff FEB 2 5 2025 938 KuvG STREET RYE BRom NY 10573 1 VILLAGE OF RYE BROOK (914)939-0668 1 BUILDING DEPARTMENT www.e,bbrook.org � --- ELECTRICAL PERMIT APPLICATION Westchester County Master Electricians License Required FOR OFFICE USE ONLY B EP#: Q�'0 Approval Date: I t 2 '1— (S�� Permit Fee: $ f Approval Signature: Other: 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: /.2 '/ZS/V//U'C ZA/V'C SBL: A)�J� —l �. S�D Zone:/"n u.6 2.Property Owner;- �A/� L • 7441VA a,44) Address: 4- fiGs/�Je�/(JF' �Ph � �.- ' `.��6J°� Cell#: I7,S`'I 6 • -76 S email: /��G�'L�N �[J ��3. Ia�er lAtActAicensed fnsta. er: 0f/N % AddressT VV Lic.#: Phone#:�)-D;- -• Cell#: emai Company Name:9/. C. DLF_DO C�CTiPi� CLC Address:l/J L9/e.4, 10.E 4,0t e 4.Proposed Electrical Work/Fixture Count: /4U,l7$,4 L / Ja- 0! e �n A66!! 5.3`d Party Electrical Inspection Agency: C e-)ls wwwwwwwwwwwwwwwwwwww,�wwwwwwwwwwww*wwwwwwwwwwwwwwwwwwww,tw*w�rwwwwww***ww*wwwwwwwwwwwwwwwrt***ww*wwwwwwwwwwww STATE OF NEW YORK,CO',TM:TY OF N1,TSTCIIESTER ) 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 plicant) state that(s)he is the 1ZQZ1g> /13P 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 ode,o the Village of Rye Brook and all other applicable laws,ordinances,and regulations. i Sworn t before me this _ Sworn t before me this ` f da f Eggu k X`r ,20 5 ��'� v� Ada f .c/a�`i p Z Si ature of Property Owne1V Signature of Ap 'c Print ame of P erty Owner Print ame of pplie f Public SRARI MEULL4 tart' ublic Nkary Publie,State of New York JOSE A GUZMAN ;io.01ME6160M � A GUZ ary Public State of New Yark gUa ii�l1iCl WesLCheater COtlitty votary Public a of New York NO.01GU6433866 1GU 866 Quallfied in Queens County Comrinlssloh 7yolm JegUary 29,20 alif+ed in Queens my 3/3/2023 mmission Expires May 23, 2026 M Commission Expires May 2 , 026 STATEWIDE • Service With lntegri�v 1.1 Main Street,Fishkill, NY 12524 1 enlGik• • Swits JOB APPLICATION tel845.202.7224 I fax 914.219.1062 1 SWISNY.com I SWISTrainingcom Office Use Elect. Permit# � r` L/ Date /C) t (�1 Bldg Permit# utility ID# Final Certificate# City/Village y',E° / 0000,< Zipin'5-77.3 Township County& �,('T Address!Z Z4 Cross Street Section Block Lot Owner Name/Address(Irdrfferent than diwve)G4 jL L . Contact Number0 _5_96__?'16$ ❑Basement ❑ 1 st Fl. ❑2nd FI. ❑3rd Fl. ❑More Than 3 FI. ®Garage ❑Attic ❑Outside ❑Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms Carbon Monox Hood Trash Compact it Sys Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Warm Draw Incandescent Fluorescent SERVICE Amperage Voltage 1 P 3P #Meters #Disconnect ❑underground ❑ New ❑Reconnect IE]Overhead ❑Change ❑Visual Re-Inspection ❑ Safety Re-inspection ❑ Re-Inspection Additional Information / ,v 1/ —;62Z 5n 'OIW—( p ;0Fr`C7P'7 F6''C T2IC Com C'A"d'e6urz2 IEC `_' �V [E L DD # FEB 2 5 2025 VILLAGE Ci-, BROOK BUILDING CEPARTMENT 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 art 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 comparty.The applicant.owner or authorized agent agrees to all the above terms and conditions as set forth for the application. Inspector Date Finalized Inspector# Company Name Date Signature Addres*.;�,?/&-AA/6w_4 City/State ©j�,��(/ (� 7" Zip Coclep/ License# //S �i Phone#.003 L 11V } State Wide Inspection Services [)) 1080 Main Street co" I MAR 10 2025 I Fishkill, NY 12524 845 202-7224 Phone S VK U S VILLAGE OF RYi= 3RO0I< 914-219-1062 Fax STATE WIDE INSPECTION SERVICES I 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: J.C.Toledo Electric Gail Flanagan John Toledo 12 Jasmine Lane 42 Richmond Hill Road, Rye Brook, NY 10573 Norwalk,CT 06854 Located at: 12 Jasmine Lane, Rye Brook, NY 10573 Section: Block: lot: Electrical Permit Number: EP 25-054 129.25 1 1.56 Certificate Number: 2025-1346 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: 12 Jasmine Lane, Rye Brook, NY 10573 The 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 5th day of March 2025. Name Quantity Rating Circuit Type EV Charger 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.